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NPI Code Detail

MEDICARE: MICHAEL W PRYSTOWSKY MD

MEDICARE:   MICHAEL W PRYSTOWSKY  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
1207V00000XObstetrics & Gynecology Physician11763SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851365746
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL W PRYSTOWSKY MD
Provider Business Mailing Address
First Line : 9291 MEDICAL PLAZA DR
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9126
Country : US
Telephone Number : 843-797-3664
Fax Number : 843-820-1007
Provider Business Practice Location Address
First Line : 9291 MEDICAL PLAZA DR
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9126
Country : US
Telephone Number : 843-797-3664
Fax Number : 843-820-1007
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 12/29/2010

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Directions to “ MICHAEL W PRYSTOWSKY MD” Practice Location

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