Provider Demographics
NPI:1326048844
Name:SZCZUKA, ANNA (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:SZCZUKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 CRESTVIEW PARK DR
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2855
Mailing Address - Country:US
Mailing Address - Phone:615-446-5121
Mailing Address - Fax:615-446-1357
Practice Address - Street 1:127 CRESTVIEW PARK DR
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2855
Practice Address - Country:US
Practice Address - Phone:615-441-4460
Practice Address - Fax:615-446-1357
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD30040207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00304441OtherRAILROAD MEDICARE PIN
TN3820937Medicaid
TN4109217OtherBLUE CROSS BLUE SHIELD TN
G67087Medicare UPIN
3820937Medicare PIN