Individual
GREGORY C MIECKOWSKI
Active
Individual
GREGORY C MIECKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
MD026705E
PA
2085N0904X
Nuclear Radiology Physician
MD026705E
PA
2085P0229X
Pediatric Radiology Physician
MD026705E
PA
2085R0202X
Diagnostic Radiology Physician
Primary
MD026705E
PA
2085R0204X
Vascular & Interventional Radiology Physician
MD026705E
PA
2085U0001X
Diagnostic Ultrasound Physician
MD026705E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009876470004
—
PA
01
—
026156
HIGHMARK
PA
01
—
300135692
RR MEDICARE
—
Enumeration date
05/10/2006
Last updated
10/17/2008
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