Provider Demographics
NPI:1992883011
Name:CHETKOWSKI, RYSZARD JERZY (MD)
Entity type:Individual
Prefix:DR
First Name:RYSZARD
Middle Name:JERZY
Last Name:CHETKOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:JERZY
Other - Last Name:CHETKOWSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2999 REGENT ST STE 101-A
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2116
Mailing Address - Country:US
Mailing Address - Phone:510-649-0440
Mailing Address - Fax:510-649-8700
Practice Address - Street 1:2999 REGENT ST STE 101-A
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2116
Practice Address - Country:US
Practice Address - Phone:510-649-0440
Practice Address - Fax:510-649-8700
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG47258207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology