MEDICARE: THOMAS KRAJEWSKI 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
1	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	162775	FL
2	390200000X	Student in an Organized Health Care Education/Training Program

Other Identifiers

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

General Provider Information

NPI Number	:	1902366255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS KRAJEWSKI MD

Provider Business Mailing Address
First Line	:	809 82ND PARKWAY
Second Line	:	GME OFFICE
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572
Country	:	US
Telephone Number	:	843-848-4679
Fax Number	:	843-848-4682

Provider Business Practice Location Address
First Line	:	901 STERTHAUS DR
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-5133
Country	:	US
Telephone Number	:	386-206-5908
Fax Number	:

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

Provider Enumeration Date	:	03/22/2019
Last Update Date	:	06/05/2023

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