Individual
PAUL G WASIELEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2122 HEALTH DRIVE SW, WYOMING, MI 49519
(616) 252-5790
(616) 252-5793
Mailing address
5900 BYRON CENTER AVE SW, MEDICAL ADMINISTRATION, WYOMING, MI 49519-9606
(616) 252-3243
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
35069937
OH
2084N0400X
Neurology Physician
Primary
4301061355
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0272084
—
OH
05
—
1164402772
—
MI
01
—
CK6240
RAILROAD MEDICARE
MI
05
—
D16078467
—
MI
Enumeration date
01/19/2006
Last updated
05/01/2018
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