| Doctor Name: | DR. MITCHELL J MAZUREK |
| NPI Number: | 1043259328 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 01040686A |
| Business Practice Address: | 1101 Glendale Blvd Valparaiso, IN - 463833767 |
| Business Phone Number: | 2194642907 |
| Business Fax Number: | 2194621054 |
| Mailing Address: | 1101 Glendale Blvd, VALPARAISO |
| State: | IN |
| Postal Code: | 463833767 |
| Phone Number: | 2194642907 |
| Fax Number: | 2194621054 |
| NPI Enumeration Date: | 06/05/2006 |
| NPI Last Update Date: | 07/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225400000X |
| License Number: | 01040686A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Rehabilitation Practitioner |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |