Individual
MR. ROMAN HYSZCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1234 NAPIER AVENUE, ST JOSEPH, MI 49085
(269) 983-8300
(269) 983-6965
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7272
(616) 361-5828
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301047417
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2750289
—
MI
01
—
3001101191
BLUE CROSS BLUE SHIELD
MI
Enumeration date
06/20/2006
Last updated
10/15/2021
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