MEDICARE: KATARZYNA KOPLEJEWSKI

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	363AM0700X	Medical Physician Assistant	5601006828	MI

General Provider Information

NPI Number	:	1528496122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATARZYNA KOPLEJEWSKI

Provider Business Mailing Address
First Line	:	PO BOX 430150
Second Line	:
City	:	PONTIAC
State	:	MI
Zip	:	48343-0150
Country	:	US
Telephone Number	:	248-253-9600
Fax Number	:	269-253-0980

Provider Business Practice Location Address
First Line	:	48980 WOODWARD AVE
Second Line	:
City	:	PONTIAC
State	:	MI
Zip	:	48342-5034
Country	:	US
Telephone Number	:	248-253-9600
Fax Number	:	248-724-7500

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

Provider Enumeration Date	:	10/17/2013
Last Update Date	:	12/12/2025

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Directions to “ KATARZYNA KOPLEJEWSKI ” Practice Location

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