Individual
JAROSLAW M AMBROZIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2750 LAUREL ST, 103, COLUMBIA, SC 29204-2038
(803) 254-5171
(803) 779-7403
Mailing address
2750 LAUREL ST, 103, COLUMBIA, SC 29204-2023
(803) 254-5171
(803) 779-7403
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21987
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080184007
RAILROAD MEDICARE
SC
05
—
T62704
—
SC
Enumeration date
05/18/2006
Last updated
07/12/2010
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