Provider Demographics
NPI:1477637189
Name:KRAWIEC, MARZENA E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARZENA
Middle Name:E
Last Name:KRAWIEC
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 1:2131 S 17TH ST
Mailing Address - Street 2:COASTAL CHILDRENS SERVICES, PLLC
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7407
Mailing Address - Country:US
Mailing Address - Phone:910-667-9402
Mailing Address - Fax:877-665-4450
Practice Address - Street 1:2131 S 17TH ST
Practice Address - Street 2:COASTAL CHILDRENS SERVICES, PLLC
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7407
Practice Address - Country:US
Practice Address - Phone:910-667-9402
Practice Address - Fax:877-665-4450
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO346962080P0214X
NC2012-018772080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC174ANOtherBCBSNC
NC5921612Medicaid
CO01346964Medicaid
CO804826Medicare UPIN
COG38016Medicare UPIN
NC5921612Medicaid