MEDICARE: DR. URSZULA A. STUDZINSKI 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	207R00000X	Internal Medicine Physician	4301062467	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00197310	OTHER	MI	RAILROAD MEDICARE
9	0P10000	OTHER	MI	MEDICARE ID-TYPE UNSPECIFIED
11	0P10000001	OTHER	MI	MEDICARE
15	0P10000001	OTHER	MI	MEDICARE BLUE CROSS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1108247142	OTHER	MI	FEDERAL BLUE CROSS BLUE SHIELD
2	G37725	OTHER	MI	PRIORITY HEALTH
3	G37726	OTHER	MI	PPOM
4	G37726	OTHER	MI	HAP
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	1108247142	OTHER	MI	BLUE CROSS BLUE SHIELD
8	0824714	OTHER	MI	BCBSM
10	923-1	OTHER	MI	TOTAL HEALTH CARE
12	1108247142	OTHER	MI	BLUE CARE NETWORK OF MICHIGAN
13	12052	OTHER	MI	CAPE HEALTH PLAN
14	G37726	OTHER	MI	SELECTCARE
16	DR82155	OTHER	MI	MCARE
17	136372	OTHER	MI	CARE CHOICES HMO
18	136372	OTHER	MI	CARE CHOICES HEALTH PLAN

General Provider Information

NPI Number	:	1558424259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. URSZULA A. STUDZINSKI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 250704
Second Line	:	6725 DALY RD
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48325-0704
Country	:	US
Telephone Number	:	248-788-7706
Fax Number	:	248-788-0276

Provider Business Practice Location Address
First Line	:	19855 WEST OUTER DR.
Second Line	:	GARRISON PLACE EAST, SUITE L-7
City	:	DEARBORN
State	:	MI
Zip	:	48124-2022
Country	:	US
Telephone Number	:	313-277-4929
Fax Number	:	313-561-1842

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	06/17/2011

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