Provider Demographics
NPI:1962419283
Name:CUKROWSKI, WALTER STANLEY II (MD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:STANLEY
Last Name:CUKROWSKI
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:32000 WOODWARD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-0998
Mailing Address - Country:US
Mailing Address - Phone:248-549-6000
Mailing Address - Fax:248-549-4923
Practice Address - Street 1:32000 WOODWARD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-0998
Practice Address - Country:US
Practice Address - Phone:248-549-6000
Practice Address - Fax:248-549-4923
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MIWC028570207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1806338551OtherBCBS
MIB0900OtherMCARE
MIP41060OtherBLUE CARE NETWORK
MI4285676OtherAETNA
MI2355976004OtherCIGNA
MI4416216Medicaid
MIP41060OtherBLUE CARE NETWORK
MI4285676OtherAETNA