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Individual

MARK UZANSKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
14555 LEVAN RD, SUITE 206, LIVONIA, MI 48154-5083
(734) 953-0990
(734) 953-0996
Mailing address
14555 LEVAN RD, SUITE 206, LIVONIA, MI 48154-5083
(734) 953-0990
(734) 953-0996

Taxonomy

Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
MU012523
MI
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
MU012523
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4114467
MI
01
5820620
BLUE CROSS BLUE SHIELD
MI
Enumeration date
07/19/2006
Last updated
01/10/2013
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