Czywczynski, Derek David

Czywczynski, Derek David is an sole proprietor health care provider with primary practice located at 104 12Th Ave Nw Suite #1, Hazen ND 58545-4100. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Czywczynski, Derek David can be contacted via phone (701) 748-5220.

Contact Information

Primary practice address
104 12Th Ave Nw Suite #1 Hazen ND 58545-4100
Phone: (701) 748-5220
Fax: (701) 748-5221
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1340 Nebraska
Eye and Vision Services Providers / Optometrist 152W00000X 681 North Dakota

Profile Details

NPI number 1427281583
LBN Legal business name Czywczynski, Derek David
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 24th, 2009
Last updated Mar 31st, 2022 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427281583 NPPES
North Dakota MEDICAID 60698
North Dakota Other 893357

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