Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 3691 | WI |
NPI | 1043357775 |
---|---|
Provider Name | Dr. Michael B Karczewski |
First Address | Brookfield, WI 53005-7192 |
Second Address | Brookfield, WI 53005-7192 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 08/07/2007 |