1962448803 NPI NUMBER - MARK ANDREW KWARTOWITZ, DO

Summary

NPI Number 1962448803
Entity Type Code Individual
Provider Legal Name MARK ANDREW KWARTOWITZ, DO
Provider Business Practice Location Address 2300 HAGGERTY RD
SUITE 1110
WEST BLOOMFIELD, MI
ZIP 48323
Practice Location Phone Number (248) 669-2000
Provider Taxonomy Code 207X00000X - Orthopaedic Surgery
Specialization
Provider Enumeration Date 6/21/2006
Last Update Date 10/17/2011

Detailed Information

NPI Number 1962448803 is assigned to an individual registered under the provider name MARK ANDREW KWARTOWITZ, DO .

The NPPES NPI record indicates the provider is a male.

The provider is physically located at:

2300 HAGGERTY RD
SUITE 1110
WEST BLOOMFIELD, MI
ZIP 48323-184
Phone: (248) 669-2000
Fax: (248) 669-2110

The enumeration date for this NPI number is 6/21/2006 and was last updated on 10/17/2011 .

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License Number State
1 207X00000X Orthopaedic Surgery 5101013112 MI View Code

Other (Legacy) Identifiers

The following legacy identifiers for this provider are available:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 H78204 MEDICARE UPIN

NPI Record

No. Field Name Field Value
1 NPI 1962448803
2 Entity Type Code 1
3 Provider Last Name Legal Name KWARTOWITZ
4 Provider First Name MARK
5 Provider Middle Name ANDREW
6 Provider Credential Text DO
7 Provider First Line Business Practice Location Address 2300 HAGGERTY RD
8 Provider Second Line Business Practice Location Address SUITE 1110
9 Provider Business Practice Location Address City Name WEST BLOOMFIELD
10 Provider Business Practice Location Address State Name MI
11 Provider Business Practice Location Address Postal Code 483232184
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 2486692000
14 Provider Business Practice Location Address Fax Number 2486692110
15 Provider Enumeration Date 6/21/2006
16 Last Update Date 10/17/2011
17 Provider Gender Code M
18 Healthcare Provider Taxonomy Code 1 207X00000X
19 Provider License Number 1 5101013112
20 Provider License Number State Code 1 MI
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Other Provider Identifier 1 H78204
23 Other Provider Identifier Type Code 1 02
24 Is Sole Proprietor N

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This page was last updated on: 5/14/2013
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.