Provider Demographics
NPI:1205903085
Name:URSZULA A. STUDZINSKI, M.D, P.C.
Entity type:Organization
Organization Name:URSZULA A. STUDZINSKI, M.D, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:URSZULA
Authorized Official - Middle Name:A
Authorized Official - Last Name:STUDZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-277-4929
Mailing Address - Street 1:P.O. BOX 250704
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48325-0704
Mailing Address - Country:US
Mailing Address - Phone:248-788-7706
Mailing Address - Fax:248-788-0276
Practice Address - Street 1:19855 WEST OUTER DR.
Practice Address - Street 2:GARRISON PLACE EAST, SUITE L-7
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2022
Practice Address - Country:US
Practice Address - Phone:313-277-4929
Practice Address - Fax:313-561-1842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301062467207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P10000OtherMEDICARE ID-TYPE UNSPECIFIED
MI0P10000001OtherMEDICARE BLUE CROSS
MI1108247142OtherBLUE CROSS BLUE SHIELD
MI1108247142OtherFEDERAL BLUE CROSS BLUE SHIELD
MIP00197310OtherRAILROAD MEDICARE
MI0P10000001OtherMEDICARE
MI1108247142OtherBLUE CARE NETWORK OF MICHIGAN
MI923-1OtherTOTAL HEALTH CARE
MIDR82155OtherMCARE
MI136372OtherCARE CHOICES HEALTH PLAN
MIG37726OtherPRIORITY HEALTH
MI12052OtherCAPE HEALTH PLAN
MI136372OtherCARE CHOICES HMO
MI3355617Medicaid
MIG37726OtherSELECTCARE
MIG37726OtherPPOM
MIG37726OtherHAP
MI136372OtherCARE CHOICES HMO
MIG37726Medicare UPIN