Individual
JACK DAVID MARKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
(317) 278-9729
Mailing address
1007 LINCOLNWAY, LA PORTE, IN 46350-3201
(219) 326-2305
(219) 326-2605
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01072267A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201172270
—
IN
01
—
P01293671
RAILROAD MEDICARE
IN
Enumeration date
09/23/2008
Last updated
10/17/2014
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