Individual
RICHARD CIESLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19401 HUBBARD DRIVE, SUITE 207 HENRY FORD HEALTH SYSTEM, DEARBORN, MI 48126
(313) 982-8261
(313) 982-8205
Mailing address
19401 HUBBARD DRIVE, SUITE 207 HENRY FORD HEALTH SYSTEM, DEARBORN, MI 48126
(313) 982-8261
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
43010161508
MI
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
43010161508
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2378930
—
OH
01
—
RC061508
CHAMPUS-CHAMPUS
—
Enumeration date
06/27/2006
Last updated
03/14/2008
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