Provider Demographics
NPI:1326092461
Name:MROCZYNSKI, MICHAEL JEROME (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JEROME
Last Name:MROCZYNSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 GREENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4651
Mailing Address - Country:US
Mailing Address - Phone:919-461-4945
Mailing Address - Fax:
Practice Address - Street 1:901 KILDAIRE FARM RD
Practice Address - Street 2:SUITE B-1
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3937
Practice Address - Country:US
Practice Address - Phone:919-460-1115
Practice Address - Fax:919-460-1266
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1692111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0841EOtherBLUE CROSS BLUE SHIELD ID
NC330653OtherACN (AMER. CHIRO. NETWORK
NC0841EOtherBLUE CROSS BLUE SHIELD ID