Provider Demographics
NPI:1629165394
Name:FIUTOWSKI, LESZEK JERZY (MD)
Entity Type:Individual
Prefix:DR
First Name:LESZEK
Middle Name:JERZY
Last Name:FIUTOWSKI
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 1:9051 AUTOVILLE DRIVE
Mailing Address - Street 2:PO BOX 1072
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20741
Mailing Address - Country:US
Mailing Address - Phone:301-982-2020
Mailing Address - Fax:301-982-2581
Practice Address - Street 1:9051 AUTOVILLE DRIVE
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20741
Practice Address - Country:US
Practice Address - Phone:301-982-2020
Practice Address - Fax:301-982-2581
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0028003207RC0000X
VA0101030820207RC0000X
DC13557207RC0000X
FLME48796207RC0000X
MA52103207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
A57065Medicare UPIN