Provider Demographics
NPI:1538148747
Name:SADOWSKI, RICHARD WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WILLIAM
Last Name:SADOWSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 GRIXDALE LN
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-3430
Mailing Address - Country:US
Mailing Address - Phone:248-363-4999
Mailing Address - Fax:248-363-9754
Practice Address - Street 1:8101 COMMERCE RD
Practice Address - Street 2:SUITE (B)
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-3517
Practice Address - Country:US
Practice Address - Phone:248-363-4999
Practice Address - Fax:248-363-9754
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-16
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005790111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F353050OtherBCBS OF MICHIGAN
MI0F35305Medicare ID - Type Unspecified
MIU17603Medicare UPIN