Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 5101017991 | MI |
NPI | 1538309711 |
---|---|
Provider Name | Monika Chmielewska |
First Address | Grand Blanc, MI 48439-2559 |
Second Address | Grand Blanc, MI 48439-2559 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2009 |
Last Update Date | 07/10/2020 |