Individual
DR. THADDEUS RAYMOND SZYDLOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
761 NORMAN DR, LEBANON, PA 17042-7497
(717) 376-1180
(717) 273-6937
Mailing address
PO BOX 300, LEBANON, PA 17042-0300
(717) 270-7780
(717) 274-9746
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD014356E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006698670002
—
PA
01
—
151298
GATEWAY HEALTH PLAN
—
01
—
50046058
CAPITAL BLUE CROSS
—
01
—
91402
HIGHMARK BLUE SHIELD
—
Enumeration date
08/23/2005
Last updated
11/21/2014
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