MEDICARE: DR. KRZYSZTOF WARSZAWSKI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	4301061381	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	700H222490	OTHER	MI	BLUE SHIELD

General Provider Information

NPI Number	:	1295711935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRZYSZTOF WARSZAWSKI M.D.

Provider Business Mailing Address
First Line	:	2011 MIDDLEBELT RD
Second Line	:
City	:	GARDEN CITY
State	:	MI
Zip	:	48135-2819
Country	:	US
Telephone Number	:	734-261-1380
Fax Number	:	734-261-0133

Provider Business Practice Location Address
First Line	:	2011 MIDDLEBELT RD
Second Line	:
City	:	GARDEN CITY
State	:	MI
Zip	:	48135-2819
Country	:	US
Telephone Number	:	734-261-1380
Fax Number	:	734-261-0133

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	02/18/2011

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