Provider Demographics
NPI:1922287325
Name:SZATKOWSKI, STEVEN PETER (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:PETER
Last Name:SZATKOWSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3427 FARR RD
Mailing Address - Street 2:
Mailing Address - City:FRUITPORT
Mailing Address - State:MI
Mailing Address - Zip Code:49415-8854
Mailing Address - Country:US
Mailing Address - Phone:231-865-6545
Mailing Address - Fax:231-865-6212
Practice Address - Street 1:3427 FARR RD
Practice Address - Street 2:
Practice Address - City:FRUITPORT
Practice Address - State:MI
Practice Address - Zip Code:49415-8854
Practice Address - Country:US
Practice Address - Phone:231-865-6545
Practice Address - Fax:231-865-6212
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005356111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4336311Medicaid
OF152770OtherBCBS
MI4336311Medicaid