Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 57.025320 | OH |
N | 208600000X | Surgeon | 57.025320 | OH |
Y | 2086S0105X | Surgery of the Hand | 69278 | MN |
NPI | 1629463328 |
---|---|
Provider Name | Grzegorz Jakub Kwiecien |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2015 |
Last Update Date | 15/06/2021 |