Individual
MARK-VICTOR SIWOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 JOHN ST STE M-124, KALAMAZOO, MI 49007-5377
(269) 341-8855
Mailing address
1061 GRANVILLE AVE, ITASCA, IL 60143-2850
(630) 742-8506
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301503605
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2015
Last updated
01/06/2021
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