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Individual

DR. MICHAEL CHARLES JEDRZYNSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
118 MAIN ST #4, STURBRIDGE, MA 01566
(508) 347-4900
(508) 347-9339
Mailing address
118 MAIN ST #4, PO BOX 1163, STURBRIDGE, MA 01566
(508) 347-4900
(508) 347-9339

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
2129
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002129
TUFTS
05
0311081
MA
01
55385
FALLON
01
GALAXY
862573
01
Y71060
BCBS
Enumeration date
08/04/2006
Last updated
01/02/2008
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