Doctor Name: | EDWARD ANTHONY BIELAK |
NPI Number: | 1215018965 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 4704221404 |
Business Practice Address: | 8160 Conover Dr Willis, MI - 481919658 |
Business Phone Number: | 7344619758 |
Business Fax Number: | |
Mailing Address: | 8160 Conover Dr, WILLIS |
State: | MI |
Postal Code: | 481919658 |
Phone Number: | 7344619758 |
Fax Number: | |
NPI Enumeration Date: | 10/18/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC0400X |
License Number: | 4704221404 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Case Management |
Taxonomy Definition: |