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Individual

DR. MARTIN M MROZEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
27 PARSONS LANE, FAYETTEVILLE, WV 25840-0957
(304) 574-2310
(304) 574-2311
Mailing address
PO BOX 957, FAYETTEVILLE, WV 25840-0957
(304) 574-2310
(304) 574-2311

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
00282
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001721891
MOUNTAIN STATE BC BS
WV
05
0099788000
WV
01
223203
ADVANTRA
WV
01
353171
ALLIANCE PPO
WV
01
4281890001
DMERC
WV
01
P00252983
RR MEDICARE
WV
Enumeration date
03/28/2006
Last updated
09/11/2008
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