Provider Demographics
NPI:1700455599
Name:JOZWIAKOWSKI, ANDREW PARKER (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:PARKER
Last Name:JOZWIAKOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 GRACELINE BLVD
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-4118
Mailing Address - Country:US
Mailing Address - Phone:314-488-3758
Mailing Address - Fax:
Practice Address - Street 1:4700 SOQUEL DR
Practice Address - Street 2:
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-2427
Practice Address - Country:US
Practice Address - Phone:831-888-9410
Practice Address - Fax:831-477-7795
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFJ4386339207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine