Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | 26787 | TN |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 26787 | TN |
NPI | 1487621926 |
---|---|
Provider Name | Dr. Mark A Brzezienski |
First Address | Chattanooga, TN 37403-2136 |
Second Address | Chattanooga, TN 37403-2136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2006 |
Last Update Date | 18/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000666487E | (05) | GA |
00666487A | (05) | TN |
04051010007 | PALMETTO DME (01) | GA |
1114640001 | PALMETTO DME (01) | TN |
1300157 | UHC INSURANCE (01) | GA |
1348080 | UHC INSURANCE (01) | TN |
2006636 | BCBS GROUP (01) | TN |
240004382 | RAILROAD MEDICARE (01) | TN |
3010836 | BCBS INSURANCE (01) | TN |
52577068004 | BCBS INSURANCE (01) | GA |
G09821 | (02) | |
GA0103 | JOHN DEERE INSURANCE (01) | GA |
P00004138 | RAILROAD MEDICARE (01) | GA |
PLF03906636 | CHAMPUS INSURANCE (01) | TN |
TN0109 | JOHN DEERE INSURANCE (01) | TN |