Provider Demographics
NPI:1457417693
Name:CHMIELEWSKI, MICHAEL D (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:CHMIELEWSKI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-4214
Mailing Address - Country:US
Mailing Address - Phone:256-549-7890
Mailing Address - Fax:256-549-7891
Practice Address - Street 1:230 S 4TH ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-4214
Practice Address - Country:US
Practice Address - Phone:256-549-7890
Practice Address - Fax:256-549-7891
Is Sole Proprietor?:No
Enumeration Date:2006-12-30
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL232213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051558977Medicaid
AL051558977Medicaid