Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 072093 | GA |
Y | 2080P0202X | Pediatric Cardiologist | C1-0013685 | DE |
N | 2080P0203X | Pediatric Critical Care Doctor | 072093 | GA |
N | 2080P0203X | Pediatric Critical Care Doctor | S1899 | TX |
NPI | 1295013308 |
---|---|
Provider Name | Wojciech A Ratajczak |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2011 |
Last Update Date | 10/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003147578A | (05) | GA |
202I376417 | (02) | GA |
P01343541 | RAILROAD MEDICARE (01) | GA |