Puzdrakiewicz, Michelle Grace
Puzdrakiewicz, Michelle Grace is an individual health care provider with primary practice located at 1700 Woodlawn Ave , Dyersburg TN 38024-2028. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Puzdrakiewicz, Michelle Grace can be contacted via phone (731) 287-4500.Contact Information
Primary practice address
1700 Woodlawn Ave
Dyersburg TN 38024-2028
Phone: (731) 287-4500
Fax: (731) 287-4804
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 308800 | Louisiana |
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 42447 | Tennessee |
Profile Details
NPI number | 1376526392 |
---|---|
LBN Legal business name | Puzdrakiewicz, Michelle Grace |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 23rd, 2005 |
Last updated | Jul 21st, 2022 - about 2 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 | 1376526392 | NPPES |
Tennessee | MEDICAID | 1510509 |
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