Provider Demographics
NPI:1982784351
Name:RADWANSKI, ZBIGNIEW (MD)
Entity Type:Individual
Prefix:
First Name:ZBIGNIEW
Middle Name:
Last Name:RADWANSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 NAUSET ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02746-1522
Mailing Address - Country:US
Mailing Address - Phone:508-990-8260
Mailing Address - Fax:508-990-0347
Practice Address - Street 1:140 NAUSET ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02746-1522
Practice Address - Country:US
Practice Address - Phone:508-990-8260
Practice Address - Fax:508-990-0347
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA39192207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA126874OtherHARVARD PILGRIM HEALTHCARE
MACOMPANY TAXID NUMBEROtherUNITED HEALTHCARE
MA1982784351OtherBLUE CROSS BLUE SHIELD OF MASSACHUSETTS
MA1982784351OtherTUFTS HEALTH CARE
MA2040026Medicaid
MACOMPANY TAXID NUMBEROtherTRICARE
MA1982784351OtherTUFTS HEALTH CARE
MAA59388Medicare UPIN