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Individual

GRAZYNA GRACE CZERWONKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2300 WESTERN AVE, MANITOWOC, WI 54220-3712
(920) 320-2249
(920) 320-3529
Mailing address
PO BOX 2290, MANITOWOC, WI 54221-2290
(920) 320-2249
(920) 320-3529

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
39618
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050071232
MEDICARE RAILROAD
WI
05
32633600
WI
01
3908063950H8
BLUE CROSS BLUE SHIELD
WI
Enumeration date
08/15/2006
Last updated
05/28/2008
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