Provider Demographics
NPI:1982785895
Name:CHRZANOWSKI, ROBERT RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:RICHARD
Last Name:CHRZANOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 BROOKSTONE CENTRE PKWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-2954
Mailing Address - Country:US
Mailing Address - Phone:706-324-4012
Mailing Address - Fax:706-324-0396
Practice Address - Street 1:1220 BROOKSTONE CENTRE PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-2954
Practice Address - Country:US
Practice Address - Phone:706-324-4012
Practice Address - Fax:706-324-0396
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA036123207K00000X
AL00021359207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
60036871OtherBCBS AL
304874OtherWELLCARE
535025OtherBCBS GA PPO
03BDBRXOtherMEDICARE PART B
535025OtherBCBS AL ALL KIDS
535025OtherBCBS HMO
535025OtherBCBS GA
00711576FOtherPEACHCARE FOR KIDS
535025OtherBCBS AL GA
535025OtherSTATE HEALTH BENEFIT P
00711576EOtherPEACHCARE FOR KIDS
GA00711576EMedicaid
535025OtherBCBS FED
535025OtherBCBS POS
GA00711576EMedicaid