Individual
ROBERT L. PIASECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7916 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 432-2297
(260) 434-6481
Mailing address
1941 S BANEY RD, STE 400, ASHLAND, OH 44805-4502
(419) 207-2375
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
02005488A
IN
207RP1001X
Pulmonary Disease Physician
Primary
34.014604
OH
207RS0012X
Sleep Medicine (Internal Medicine) Physician
02005488A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1151100074
BLUE CROSS BLUE SHIELD MI
MI
05
—
1790854982
—
MI
05
—
300017715
—
IN
01
—
P55547
BCNM INDIVIDUAL NUMBER
MI
Enumeration date
11/06/2006
Last updated
11/17/2020
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