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Individual

MARK W SAWKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
25000 HALL RD, STE 1, WOODHAVEN, MI 48183-5112
(734) 675-1280
(734) 675-1678
Mailing address
25000 HALL RD, STE 1, WOODHAVEN, MI 48183-5112
(734) 675-1280
(734) 675-1678

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MS054908
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0108281382
BCBS
01
080066594
RAILROAD
01
0828138
BCN
MI
01
0828138
MEDICARE
01
0H23901
BC LEGACY NUMBER
MI
01
2391865003
CIGNA
01
38-3246455
TAX ID#
01
4554977
AETNA
01
C7583
M-CARE
01
F07916
UPIN
01
MS054908
ST. LIC#
01
P120121
CARE CHOICES
Enumeration date
07/07/2005
Last updated
12/28/2021
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