Provider Demographics
NPI:1356398028
Name:SADOWSKI, JASON BRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:BRIAN
Last Name:SADOWSKI
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 1:26025 LAHSER RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-2601
Mailing Address - Country:US
Mailing Address - Phone:248-663-1900
Mailing Address - Fax:
Practice Address - Street 1:26025 LAHSER RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-2601
Practice Address - Country:US
Practice Address - Phone:248-663-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301077020207X00000X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F31114OtherBCBS
MI0F33583OtherBCBS DME
MI0767220001OtherADMINISTAR FEDERAL
MI4863479Medicaid
MI0F31114OtherBCBS
MI0F33583OtherBCBS DME
MI4863479Medicaid