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NPI Code Detail

MEDICARE: DR. MARK JAN SZUMILEWICZ M.D.

MEDICARE: DR. MARK JAN SZUMILEWICZ 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
1207P00000XEmergency Medicine PhysicianJ5032TX

General Provider Information

NPI Number : 1760430631
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK JAN SZUMILEWICZ M.D.
Provider Business Mailing Address
First Line : 200 CORPORATE BLVD
Second Line : SUITE 201
City : LAFAYETTE
State : LA
Zip : 70508-3870
Country : US
Telephone Number : 800-893-9698
Fax Number :
Provider Business Practice Location Address
First Line : 5501 S EXPRESSWAY 77
Second Line :
City : HARLINGEN
State : TX
Zip : 78550-3213
Country : US
Telephone Number : 956-423-3643
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 07/08/2007

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