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NPI Code Detail

MEDICARE: MARIE KONWINSKI

MEDICARE:   MARIE  KONWINSKI
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
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General Provider Information

NPI Number : 1932462710
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIE KONWINSKI
Provider Business Mailing Address
First Line : 20712 ALGER ST
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48080-3712
Country : US
Telephone Number : 810-543-0003
Fax Number :
Provider Business Practice Location Address
First Line : 20712 ALGER ST
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48080-3712
Country : US
Telephone Number : 810-543-0003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2012
Last Update Date : 02/21/2013

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Directions to “ MARIE KONWINSKI ” Practice Location

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