MEDICARE: JOLANTA SOBOTKA-CZARNECKI MD PLLC

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	207RR0500X	Rheumatology Physician	JS060311	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1102503161	OTHER	MI	BLUE CROSS BLUE SHIELD
2	5366501	OTHER	MI	AETNA
3	C4922	OTHER	MI	MCARE
4	P60832	OTHER	MI	BLUE CARE NETWORK
5	0989021	OTHER	MI	HEALTH PLUS
6	G51998	OTHER	MI	UPIN
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295901288
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOLANTA SOBOTKA-CZARNECKI MD PLLC

Provider Business Mailing Address
First Line	:	G-5085 WEST BRISTOL RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48507-2922
Country	:	US
Telephone Number	:	810-230-2400
Fax Number	:	810-230-1616

Provider Business Practice Location Address
First Line	:	G-5085 WEST BRISTOL RD.
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48507-2922
Country	:	US
Telephone Number	:	810-230-2400
Fax Number	:	810-230-1616

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	KRISTEN MARIE SOPKO
Credential	:
Telephone Number	:	810-230-1790

Provider Enumeration Date	:	04/30/2008
Last Update Date	:	03/27/2015

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