Provider Demographics
NPI:1578875217
Name:WYKRETOWICZ, JEDRZEJ MICHAL (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JEDRZEJ
Middle Name:MICHAL
Last Name:WYKRETOWICZ
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Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:6350 CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4107
Mailing Address - Country:US
Mailing Address - Phone:757-213-5700
Mailing Address - Fax:757-213-5701
Practice Address - Street 1:6251 E VIRGINIA BEACH BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-2800
Practice Address - Country:US
Practice Address - Phone:757-466-8683
Practice Address - Fax:757-466-8892
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2022-06-29
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Provider Licenses
StateLicense IDTaxonomies
MI4301109160207RH0003X
VA0101274951207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology