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1477503217

NPI Code Detail

MEDICARE: MICHAEL VALENTINE KURZAWA MD

MEDICARE: MICHAEL VALENTINE KURZAWA 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	207Q00000X	Family Medicine Physician	4301406542	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	700E012740	OTHER	MI	BCBSM GROUP NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477503217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL VALENTINE KURZAWA MD

Provider Business Mailing Address
First Line	:	43750 GARFIELD RD
Second Line	:	SUITE 104
City	:	CLINTON TWP
State	:	MI
Zip	:	48038-1135
Country	:	US
Telephone Number	:	586-226-6865
Fax Number	:	586-226-6880

Provider Business Practice Location Address
First Line	:	25990 CROCKER BLVD
Second Line	:
City	:	HARRISON TOWNSHIP
State	:	MI
Zip	:	48045-3450
Country	:	US
Telephone Number	:	586-466-5211
Fax Number	:	586-466-5230

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	01/17/2012

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Directions to “ MICHAEL VALENTINE KURZAWA MD” Practice Location

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