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NPI Code Detail

MEDICARE: DR. JOSEPH ROBERT MODZELEWSKI M.D.

MEDICARE: DR. JOSEPH ROBERT MODZELEWSKI 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
1207ZC0500XCytopathology Physician19654SC
2207ZP0102XAnatomic Pathology & Clinical Pathology Physician19654SC

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 : 1942272745
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH ROBERT MODZELEWSKI M.D.
Provider Business Mailing Address
First Line : PO BOX 30309
Second Line :
City : CHARLESTON
State : SC
Zip : 29417-0309
Country : US
Telephone Number : 843-554-9300
Fax Number : 843-556-8780
Provider Business Practice Location Address
First Line : 2435 FOREST DR
Second Line : C/O PROVIDENCE HOSPITAL
City : COLUMBIA
State : SC
Zip : 29204-2026
Country : US
Telephone Number : 803-256-5336
Fax Number : 803-256-5454
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 02/29/2008

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