Provider Demographics
NPI:1811990500
Name:SZCZUKOWSKI, MYRON JAMES JR (MD)
Entity type:Individual
Prefix:DR
First Name:MYRON
Middle Name:JAMES
Last Name:SZCZUKOWSKI
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:510 IDLEWILD AVE
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3824
Mailing Address - Country:US
Mailing Address - Phone:410-820-8226
Mailing Address - Fax:410-820-8405
Practice Address - Street 1:510 IDLEWILD AVE
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3824
Practice Address - Country:US
Practice Address - Phone:410-820-8226
Practice Address - Fax:410-820-8405
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0034339207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD445751000Medicaid
MDCF17-0009OtherCAREFIRST
MD494171ZP1Medicare PIN
MDB70243Medicare UPIN