Provider Demographics
NPI:1417905258
Name:KRZYMOWSKI, GEORGE ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ALAN
Last Name:KRZYMOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 LAKEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-9519
Mailing Address - Country:US
Mailing Address - Phone:906-249-1672
Mailing Address - Fax:
Practice Address - Street 1:850 W BARAGA AVE
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4550
Practice Address - Country:US
Practice Address - Phone:906-449-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301056986207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E88501Medicare UPIN
MI0E26202004Medicare PIN
MI0C16002044Medicare PIN
0C16002Medicare PIN