Provider Demographics
NPI:1033172515
Name:OPIELA, JAROSLAW PIOTR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAROSLAW
Middle Name:PIOTR
Last Name:OPIELA
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 1:115 DUKE RD
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-9585
Mailing Address - Country:US
Mailing Address - Phone:252-814-4758
Mailing Address - Fax:252-756-2787
Practice Address - Street 1:316 S MCCASKEY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2150
Practice Address - Country:US
Practice Address - Phone:252-792-0022
Practice Address - Fax:252-792-0027
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G83182Medicare UPIN