Organization
ROBERT B GRZYWACZ DPM A PROFESSIONAL CORPORATION
Active
Other names
Desert Podiatry
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT B GRZYWACZ DPM (OWNER)
(702) 733-7617
Entity
Organization
Contact information
Practice address
3221 E WARM SPRINGS RD, LAS VEGAS, NV 89120-3157
(702) 733-7617
(702) 733-1732
Mailing address
3221 E WARM SPRINGS RD, LAS VEGAS, NV 89120-3157
(702) 733-7617
(702) 733-1732
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
793965375
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137141EQ
PREFERRED CARE
—
01
—
37963
MEDICARE SECONDARY
—
01
—
P00058662
RAILROAD MEDICARE
NV
01
—
V37962
GEHA
—
01
—
V37963
MEDICARE CLAIMS
—
Enumeration date
09/07/2005
Last updated
05/23/2008
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