Individual
PETER MARK GRZESIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-3271
(508) 856-5911
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
287786
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110126355A
—
MA
Enumeration date
05/15/2014
Last updated
07/29/2021
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