Provider Demographics
NPI:1578522173
Name:SRODULSKI, ZBIGNIEW MARK (MD)
Entity Type:Individual
Prefix:
First Name:ZBIGNIEW
Middle Name:MARK
Last Name:SRODULSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1850 WHITES RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-4801
Mailing Address - Country:US
Mailing Address - Phone:269-343-3900
Mailing Address - Fax:269-343-5640
Practice Address - Street 1:1850 WHITES RD
Practice Address - Street 2:SUITE 3
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-4801
Practice Address - Country:US
Practice Address - Phone:269-343-3900
Practice Address - Fax:269-343-5640
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301407455207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine