Kucharewicz, Jacek M
Kucharewicz, Jacek M is an individual health care provider with primary practice located at 540 Trinity Ln N #8412, St Petersburg FL 33716-1278. He recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Kucharewicz, Jacek M can be contacted via phone (910) 409-4207.Contact Information
Primary practice address
540 Trinity Ln N #8412
St Petersburg FL 33716-1278
Phone: (910) 409-4207
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | TRAINING LICENSE | New Jersey |
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 34101 | South Carolina |
Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | ME126030 | Florida |
Profile Details
NPI number | 1437438710 |
---|---|
LBN Legal business name | Kucharewicz, Jacek M |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 4th, 2011 |
Last updated | Oct 18th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1437438710 | NPPES |
South Carolina | Other | 34101 | STATE LICENSE |
South Carolina | Other | ME126030 | STATE LICENSE |
South Carolina | Other | 0101255118 | STATE LICENSE |
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