MEDICARE: MR. ANDRZEJ EDWARD KALINSKI 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	261QM1300X	Multi-Specialty Clinic/Center	22-17182	SC

General Provider Information

NPI Number	:	1639179203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDRZEJ EDWARD KALINSKI M.D.

Provider Business Mailing Address
First Line	:	1243 EBENEZER RD
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-2353
Country	:	US
Telephone Number	:	803-366-9393
Fax Number	:	803-366-9396

Provider Business Practice Location Address
First Line	:	1243 EBENEZER RD
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-2353
Country	:	US
Telephone Number	:	803-366-9393
Fax Number	:	803-366-9396

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

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	02/01/2012

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