Individual
JAROSLAW MICHALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
965 MATTOX DR, SULLIVAN, MO 63080-2365
(573) 860-6000
(573) 860-6016
Mailing address
965 MATTOX DR, SULLIVAN, MO 63080-2365
(573) 860-6000
(573) 860-6016
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
114756
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203776505
—
MO
Enumeration date
08/31/2006
Last updated
05/17/2021
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