Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | ME91461 | FL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 25MA08681200 | NJ |
N | 207VG0400X | Gynecologist | 25MA08681200 | NJ |
N | 207VG0400X | Gynecologist | ME91461 | FL |
NPI | 1164410643 |
---|---|
Provider Name | Dr. Martin P Michalewski |
First Address | Belmar, NJ 07719-2912 |
Second Address | Asbury Park, NJ 07712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2005 |
Last Update Date | 05/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0225347 | (05) | NJ |
271287300 | (05) | FL |
I22295 | (02) |