Individual
MARIUSZ A WASIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
333 COTTMAN AVE, PHILADELPHIA, PA 19111
(215) 728-3675
(215) 728-2848
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 728-3675
(215) 728-2848
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
MD049675L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015674870001
—
PA
Enumeration date
06/18/2006
Last updated
03/27/2019
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