MEDICARE: PAULA SCIZAK 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	208D00000X	General Practice Physician	20094	KY

General Provider Information

NPI Number	:	1447527270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA SCIZAK M.D.

Provider Business Mailing Address
First Line	:	4112 COLORADO AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-4732
Country	:	US
Telephone Number	:	615-423-5830
Fax Number	:

Provider Business Practice Location Address
First Line	:	4112 COLORADO AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-4732
Country	:	US
Telephone Number	:	615-423-5830
Fax Number	:

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

Provider Enumeration Date	:	11/22/2011
Last Update Date	:	11/28/2011

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