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:
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Health care specialties

SpecialtyCodeLicense #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 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 1376526392 NPPES
Tennessee MEDICAID 1510509

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