Provider Demographics
NPI:1255302345
Name:TURKIEWICZ, MARY LOUISE (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:LOUISE
Last Name:TURKIEWICZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 BEE ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-5703
Mailing Address - Country:US
Mailing Address - Phone:843-577-5011
Mailing Address - Fax:
Practice Address - Street 1:109 BEE ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-5703
Practice Address - Country:US
Practice Address - Phone:843-577-5011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1878992085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000511574008OtherBCBS
NY1609206OtherINDEPENDENT HEALTH
NY00026681804OtherUNIVERA HEALTHCARE
NY040426000332OtherFIDELIS CARE OF NEW YORK
NY146156FFOtherPREFERRED CARE
NY300080553OtherRR MEDICARE
NY01371613Medicaid
NY040426000332OtherFIDELIS CARE OF NEW YORK
NY1609206OtherINDEPENDENT HEALTH
NY01371613Medicaid