Individual
DR. MITCHELL J MAZUREK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 GLENDALE BLVD, VALPARAISO, IN 46383-3767
(219) 464-2907
(219) 462-1054
Mailing address
1101 GLENDALE BLVD, VALPARAISO, IN 46383-3767
(219) 464-2907
(219) 462-1054
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
01040686A
IN
225400000X
Rehabilitation Practitioner
01040686A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100097710
—
IN
Enumeration date
06/05/2006
Last updated
07/17/2014
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