Provider Demographics
NPI:1659340610
Name:PIENKOWSKI, MAREK M (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MAREK
Middle Name:M
Last Name:PIENKOWSKI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7417 KINGSTON PIKE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5606
Mailing Address - Country:US
Mailing Address - Phone:865-584-4112
Mailing Address - Fax:865-588-5140
Practice Address - Street 1:7417 KINGSTON PIKE
Practice Address - Street 2:SUITE 101
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5606
Practice Address - Country:US
Practice Address - Phone:865-584-4112
Practice Address - Fax:865-588-5140
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD15320207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0202905OtherBCBSTN
VA059803OtherBCBSVA
TN0030601OtherBCBSTN
TN3006456Medicaid
VA067080OtherBCBSVA
TN3006457Medicaid
TN0056936OtherBCBSTN
TN0166234OtherBCBSTN
VA064686OtherBCBSVA
TN3006458Medicaid
TN30065459Medicaid
TN2004413OtherBCBSTN
TN3006450Medicaid
TN2004413OtherBCBSTN
VA067080OtherBCBSVA
VA059803OtherBCBSVA
TN0202905OtherBCBSTN
TN3006450Medicaid
TN30065459Medicaid