Individual
JOHN M MAZZARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1101 W UNIVERSITY DR, ROCHESTER, MI 48307-1863
(248) 652-5354
(248) 652-5861
Mailing address
130 VREELAND DR, ROCHESTER HILLS, MI 48309-1906
(248) 375-9019
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704131712
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1819520
—
MI
01
—
430F364550
BCBS
MI
Enumeration date
01/19/2007
Last updated
03/05/2012
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