Provider Demographics
NPI:1730348111
Name:TROJANOWSKI, MARCIN ANDRZEJ (MD)
Entity type:Individual
Prefix:
First Name:MARCIN
Middle Name:ANDRZEJ
Last Name:TROJANOWSKI
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 1:720 HARRISON AVE
Mailing Address - Street 2:DOB 503
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2371
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:725 ALBANY ST
Practice Address - Street 2:SHAPIRO 7 SUITE B
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2526
Practice Address - Country:US
Practice Address - Phone:617-638-1460
Practice Address - Fax:617-638-5226
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA268421207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL128986Medicaid
AL102I662262Medicare PIN
AL051117719OtherBCBS
AL128987Medicaid
AL128989Medicaid
AL051117718OtherBCBS
AL051117715OtherBCBS
MS08372831Medicaid