MEDICARE: DR. HENRY PAUL SZELAG D.O.

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	207Q00000X	Family Medicine Physician	5101009907	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0853700035	OTHER	MI	BCBS
2	0853701254	OTHER	MI	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316044613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HENRY PAUL SZELAG D.O.

Provider Business Mailing Address
First Line	:	3520 NORTH WOODRUFF ROAD
Second Line	:	PO BOX 36
City	:	WEIDMAN
State	:	MI
Zip	:	48893
Country	:	US
Telephone Number	:	989-644-3329
Fax Number	:	989-644-3724

Provider Business Practice Location Address
First Line	:	3520 NORTH WOODRUFF ROAD
Second Line	:
City	:	WEIDMAN
State	:	MI
Zip	:	48893
Country	:	US
Telephone Number	:	989-644-3329
Fax Number	:	989-644-3724

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	10/22/2007

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