MEDICARE: DR. MICHAEL PIRKOWSKI 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	2085R0001X	Radiation Oncology Physician	ME60102	FL

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386646461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL PIRKOWSKI M.D.

Provider Business Mailing Address
First Line	:	12109 COUNTY ROAD 103
Second Line	:
City	:	OXFORD
State	:	FL
Zip	:	34484-2951
Country	:	US
Telephone Number	:	352-205-8981
Fax Number	:	352-391-6498

Provider Business Practice Location Address
First Line	:	1620 MASON AVE
Second Line	:	SUITE E
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-7802
Country	:	US
Telephone Number	:	386-506-5116
Fax Number	:

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	03/08/2017

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