Provider Demographics
NPI:1699749218
Name:MYSLIWIEC, VINCENT (MD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:MYSLIWIEC
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:41 LESCHI DR
Mailing Address - Street 2:
Mailing Address - City:STEILACOOM
Mailing Address - State:WA
Mailing Address - Zip Code:98388-1513
Mailing Address - Country:US
Mailing Address - Phone:253-968-2103
Mailing Address - Fax:253-968-2284
Practice Address - Street 1:DEPARTMENT OF PULMONARY MEDICINE: MAMC
Practice Address - Street 2:9040 FITZSIMMONS AVE
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-968-2103
Practice Address - Fax:253-968-2284
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HI10206207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAVADOOMedicare UPIN