Provider Demographics
NPI:1255499950
Name:ROBERT WOZNIAK MD PA
Entity Type:Organization
Organization Name:ROBERT WOZNIAK MD PA
Other - Org Name:LANCASTER ENDOCRINOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WOZNIAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-329-3899
Mailing Address - Street 1:410 S HERLONG AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8349
Mailing Address - Country:US
Mailing Address - Phone:803-329-3899
Mailing Address - Fax:803-329-4377
Practice Address - Street 1:410 S HERLONG AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-8349
Practice Address - Country:US
Practice Address - Phone:803-329-3899
Practice Address - Fax:803-329-4377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21019207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1942282470OtherNPI INDIVIDUAL
SC210195Medicaid
SC210195Medicaid
SCH00872Medicare UPIN
NC2329149Medicare PIN