Provider Demographics
NPI:1548257249
Name:MISZKIEWICZ, STEVEN C (MD)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:C
Last Name:MISZKIEWICZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:301 EXPLORER ST
Mailing Address - Street 2:
Mailing Address - City:GWINN
Mailing Address - State:MI
Mailing Address - Zip Code:49841-2813
Mailing Address - Country:US
Mailing Address - Phone:906-481-8586
Mailing Address - Fax:906-265-4245
Practice Address - Street 1:1500 W ICE LAKE RD
Practice Address - Street 2:
Practice Address - City:IRON RIVER
Practice Address - State:MI
Practice Address - Zip Code:49935-8509
Practice Address - Country:US
Practice Address - Phone:906-265-5378
Practice Address - Fax:906-265-5378
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2024-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCMD14419207Q00000X
SC14419207Q00000X
MI4301512874207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC144196Medicaid
MI1548257249Medicaid
NC890623JMedicaid
NC890623JMedicaid
NCB55160Medicare UPIN