Provider Demographics
NPI:1619592045
Name:SZYMANSKI, RAPHAEL MORGANTE (MD)
Entity Type:Individual
Prefix:DR
First Name:RAPHAEL
Middle Name:MORGANTE
Last Name:SZYMANSKI
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 1:6700 N ROCHESTER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-4378
Mailing Address - Country:US
Mailing Address - Phone:248-650-1520
Mailing Address - Fax:
Practice Address - Street 1:6700 N ROCHESTER RD STE 100
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48306-4378
Practice Address - Country:US
Practice Address - Phone:248-650-1520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI4301509909207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program