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Individual
JACOB MARK CZAJKA
Active
Individual
JACOB MARK CZAJKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601010457
MI
363A00000X
Physician Assistant
Primary
PA9115985
FL
363AS0400X
Surgical Physician Assistant
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115551000
—
FL
01
—
C200356585308
MICHIGAN STATE LICENSE
MI
Enumeration date
08/28/2019
Last updated
11/09/2022
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