Individual
WITOLD S. NIESLUCHOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
206 JOE V. KNOX AVENUE, SUITE H, MOORESVILLE, NC 28117-8104
(424) 488-3467
(704) 661-1396
Mailing address
206 JOE V. KNOX AVENUE, SUITE H, MOORESVILLE, NC 28117-8104
(424) 488-3467
(704) 661-1396
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
186439
NC
174400000X
Specialist
A40288
CA
202K00000X
Phlebology Physician
Primary
00483
NC
2086S0129X
Vascular Surgery Physician
186439
NC
Other
Enumeration date
06/05/2006
Last updated
06/17/2014
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