Provider Demographics
NPI:1558424259
Name:STUDZINSKI, URSZULA A (MD)
Entity Type:Individual
Prefix:DR
First Name:URSZULA
Middle Name:A
Last Name:STUDZINSKI
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:PO BOX 250704
Mailing Address - Street 2:6725 DALY RD
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48325-0704
Mailing Address - Country:US
Mailing Address - Phone:248-788-7706
Mailing Address - Fax:248-788-0276
Practice Address - Street 1:19855 WEST OUTER DR.
Practice Address - Street 2:GARRISON PLACE EAST, SUITE L-7
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2022
Practice Address - Country:US
Practice Address - Phone:313-277-4929
Practice Address - Fax:313-561-1842
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301062467207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1108247142OtherFEDERAL BLUE CROSS BLUE SHIELD
MIG37725OtherPRIORITY HEALTH
MIG37726OtherPPOM
MIG37726OtherHAP
MIP00197310OtherRAILROAD MEDICARE
MI3355617Medicaid
MI1108247142OtherBLUE CROSS BLUE SHIELD
MI0824714OtherBCBSM
MI0P10000OtherMEDICARE ID-TYPE UNSPECIFIED
MI923-1OtherTOTAL HEALTH CARE
MI0P10000001OtherMEDICARE
MI1108247142OtherBLUE CARE NETWORK OF MICHIGAN
MI12052OtherCAPE HEALTH PLAN
MIG37726OtherSELECTCARE
MI0P10000001OtherMEDICARE BLUE CROSS
MIDR82155OtherMCARE
MI136372OtherCARE CHOICES HMO
MI136372OtherCARE CHOICES HEALTH PLAN
MI136372OtherCARE CHOICES HEALTH PLAN
MIG37726OtherSELECTCARE