Provider Demographics
NPI:1386867232
Name:ZBYTEK, BLAZEJ (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:BLAZEJ
Middle Name:
Last Name:ZBYTEK
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 SHOPPINGWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-1734
Mailing Address - Country:US
Mailing Address - Phone:870-394-4906
Mailing Address - Fax:
Practice Address - Street 1:260 SHOPPINGWAY BLVD
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-1734
Practice Address - Country:US
Practice Address - Phone:870-394-4906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA080649207ZD0900X
TNMD45415207ZP0102X
390200000X
ARE-12221207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program