Henryk Czeslaw Pietrus, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

HP 065997 Issued in MI

Practice address

6940 Dixie Hwy
Bridgeport, MI 48722-9760

Phone

(989) 746-0933

Fax

(989) 746-5070

NPI assigned

Jul 9, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258675200000",
    "number": "1063445104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6940 DIXIE HWY",
            "city": "BRIDGEPORT",
            "state": "MI",
            "postal_code": "487229760",
            "telephone_number": "989-746-0933",
            "fax_number": "989-746-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6940 DIXIE HWY",
            "city": "BRIDGEPORT",
            "state": "MI",
            "postal_code": "487229760",
            "telephone_number": "989-746-0933",
            "fax_number": "989-746-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETRUS",
        "first_name": "HENRYK",
        "middle_name": "CZESLAW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2009-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "HP 065997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4301156",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joan Renee Patten, BSW
• Sara Jean Peeples, BA
• Kimberly Peters
• Kelsey Peterson
• Emilio Philpotts
• Eleezia Darlene Piirala
• Sawyer Plume, BA
• Victoria Poletti
• Dale James Potter, MA
• Joshua Aaron Powell

• Family Medicine Physician in Bridgeport, MI
• Providers in Bridgeport, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.