Provider Demographics
NPI:1992983944
Name:OBRZUT, MICHAL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAL
Middle Name:
Last Name:OBRZUT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32-36 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-2122
Mailing Address - Country:US
Mailing Address - Phone:607-729-1999
Mailing Address - Fax:
Practice Address - Street 1:32-36 HARRISON ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-2122
Practice Address - Country:US
Practice Address - Phone:607-217-1021
Practice Address - Fax:607-217-1027
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0459242085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology