Provider Demographics
NPI:1306831441
Name:CHMIELEWSKI, PAUL W (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:W
Last Name:CHMIELEWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 15527
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277-1527
Mailing Address - Country:US
Mailing Address - Phone:941-379-8481
Mailing Address - Fax:941-379-3781
Practice Address - Street 1:5401 SAWYER RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2444
Practice Address - Country:US
Practice Address - Phone:941-371-7700
Practice Address - Fax:941-379-3781
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73577208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00659606OtherMEDICARE RAILROAD
FL070269200Medicaid
FL41561OtherBCBS
FL41561OtherBCBS
FLP00659606OtherMEDICARE RAILROAD