MEDICARE: FRANCIS PAUL SURDAKOWSKI MD

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	207RC0000X	Cardiovascular Disease Physician	11849	AZ

General Provider Information

NPI Number	:	1346241445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCIS PAUL SURDAKOWSKI MD

Provider Business Mailing Address
First Line	:	14619 N 14TH DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85023-5194
Country	:	US
Telephone Number	:	602-228-3069
Fax Number	:

Provider Business Practice Location Address
First Line	:	14619 N 14TH DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85023-5194
Country	:	US
Telephone Number	:	602-228-3069
Fax Number	:

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	06/14/2022

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