Provider Demographics
NPI:1932252301
Name:ROZA K.ADAMCZYK,MD,PC
Entity Type:Organization
Organization Name:ROZA K.ADAMCZYK,MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LUBA
Authorized Official - Middle Name:K
Authorized Official - Last Name:ARONSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-227-1102
Mailing Address - Street 1:522 W SOLOMON ST
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-2834
Mailing Address - Country:US
Mailing Address - Phone:770-227-1102
Mailing Address - Fax:770-227-3082
Practice Address - Street 1:522 W SOLOMON ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-2834
Practice Address - Country:US
Practice Address - Phone:770-227-1102
Practice Address - Fax:770-227-3082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10058864OtherAMERIGROUP - MEDICAID
GA130022404OtherPALMETTO MCARE RAILROAD
GADG4707OtherPALMETTO MCARE RAILROAD
GA00347234GMedicaid
GA1020061OtherCIGNA
GA11363OtherUNITED HEALTHCARE
GA21003404108OtherBEECHSTREET
GA328469OtherWELLCARE - MEDICAID
GA4567388OtherAETNA - PPO
GA00347234BMedicaid
GA117715OtherPEACHSTATE HEALTHCARE
GA2339303OtherAETNA-HMO
GA52239078001OtherBLUE CROSS BLUE SHIELD
GA52239078002OtherBLUE CROSS BLUE SHIELD
GA130022404OtherPALMETTO MCARE RAILROAD
GA21003404108OtherBEECHSTREET
GA13BDDFVMedicare PIN