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Individual
TED PODESZWA
Active
Individual
TED PODESZWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101005210
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2875701
—
MI
01
—
4102835
AETNA
MI
01
—
B4340
MCARE
MI
01
—
P46981
BLUE CROSS
MI
Enumeration date
06/22/2006
Last updated
07/08/2007
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