Provider Demographics
NPI:1033189766
Name:JAWORSKI, ANDRZEJ J (MD)
Entity Type:Individual
Prefix:
First Name:ANDRZEJ
Middle Name:J
Last Name:JAWORSKI
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 1:1200 J D ANDERSON DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3494
Mailing Address - Country:US
Mailing Address - Phone:304-598-2801
Mailing Address - Fax:304-599-6463
Practice Address - Street 1:1000 MON HEALTH MEDICAL PARK DR
Practice Address - Street 2:SUITE 1100
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-1104
Practice Address - Country:US
Practice Address - Phone:304-598-2801
Practice Address - Fax:304-599-6364
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV15540207RS0012X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV290003789OtherRAILROAD MEDICARE
WV0071863000Medicaid
WVA60097Medicare UPIN
WV0071863000Medicaid