Individual
MARK DAWYDOWYCZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2515 S 88TH ST, WEST ALLIS, WI 53227-2723
(414) 630-3499
Mailing address
2515 S. 88TH ST, WEST ALLIS, WI 53227
(414) 630-3499
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3447-23
WI
Other
Enumeration date
11/03/2014
Last updated
11/30/2021
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