Provider Demographics
NPI:1831452671
Name:BZDAWKA, WILLIAM F (PHARMD, MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:F
Last Name:BZDAWKA
Suffix:
Gender:M
Credentials:PHARMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 SOUTHFORK RD STE 280
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-3287
Mailing Address - Country:US
Mailing Address - Phone:314-892-6565
Mailing Address - Fax:
Practice Address - Street 1:12700 SOUTHFORK RD STE 280
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128
Practice Address - Country:US
Practice Address - Phone:314-892-6565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010037345183500000X
WI15693040183500000X
WI64188-20207R00000X
MO20109033505207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No183500000XPharmacy Service ProvidersPharmacist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine