Individual
DR. LAWRENCE E MIECZKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3080 ACKERMAN BLVD STE 220, KETTERING, OH 45429-3658
(937) 294-3228
(937) 294-3250
Mailing address
3080 ACKERMAN BLVD STE 220, KETTERING, OH 45429-3658
(937) 294-3228
(937) 394-3250
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OH35-05-2076
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000020506
ANTHEM
OH
01
—
04-20157
UNITEDHEALTHCARE
OH
05
—
0603574
—
OH
01
—
0634819
AETNA LIFE INSURANCE CO
OH
01
—
E00311469434
AETNA
OH
Enumeration date
08/31/2005
Last updated
04/16/2018
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