Provider Demographics
NPI:1851518674
Name:SZACHOWICZ, EDWARD HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:HENRY
Last Name:SZACHOWICZ
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 1:4999 FRANCE AV. SO.
Mailing Address - Street 2:SUITE #210
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410
Mailing Address - Country:US
Mailing Address - Phone:952-835-5665
Mailing Address - Fax:
Practice Address - Street 1:7373 FRANCE AV. SO.
Practice Address - Street 2:SUITE #508
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4549
Practice Address - Country:US
Practice Address - Phone:952-835-5665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN25911207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MND81101Medicare UPIN