Individual
DR. STEFAN MIANOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
199 OAK ST, PEMBROKE, MA 02359-1953
(781) 829-7000
Mailing address
1412 PAUL EASON DR, CHESAPEAKE, VA 23322-2794
(954) 328-3616
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101265906
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2015
Last updated
11/17/2020
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