Provider Demographics
NPI:1952418410
Name:SOBOTKA-CZARNECKI, JOLANTA (MD)
Entity Type:Individual
Prefix:MRS
First Name:JOLANTA
Middle Name:
Last Name:SOBOTKA-CZARNECKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:JOLANTA
Other - Middle Name:
Other - Last Name:SOBOTKA-CZARNECKI MD PLLC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:G-5085 WEST BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2922
Mailing Address - Country:US
Mailing Address - Phone:810-230-2400
Mailing Address - Fax:810-230-1616
Practice Address - Street 1:1311 S LINDEN RD STE C
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3428
Practice Address - Country:US
Practice Address - Phone:810-230-2400
Practice Address - Fax:810-230-1616
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJS060311207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1102503161OtherBLUE CROSS BLUE SHIELD
MIP60832OtherBLUE CARE NETWORK
MI3360475Medicaid
MIC4922OtherM-CARE
MI0989021OtherHEALTH PLUS
MI5366501OtherAETNA
MIG51998Medicare UPIN
MI0989021OtherHEALTH PLUS