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Individual

MR. MAREK A STAWISKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
833 MICHIGAN ST NE, SUITE 102, GRAND RAPIDS, MI 49503-3523
(616) 459-8209
(616) 459-0313
Mailing address
833 MICHIGAN ST NE, SUITE 102, GRAND RAPIDS, MI 49503-3523
(616) 459-8209
(616) 459-0313

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
4301030349
MI
207ND0900X
Dermatopathology Physician
Primary
4301030349
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0724106641
BCBSM
MI
05
4687587
MI
01
P00236428
RRB MEDICARE
MI
Enumeration date
07/26/2005
Last updated
01/22/2014
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