Steve Kujacznski, D.O.
Individual provider Active NPI Family Medicine Physician · Cassopolis, MI
NPI 1689625469 · NPPES record last updated Feb 25, 2015
Key facts
- NPI
- 1689625469
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 5101008922 (MI)
- Practice address
- 261 M 62
Cassopolis, MI 49031-1034 - Phone
- (269) 445-3874
- Fax
- (269) 445-2076
- NPI assigned
- May 15, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101008922 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radiology Associates of Berrien County PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 5101008922 | MI | |
| Family Medicine Physician | 207Q00000X | 5101008922 | MI | Yes |
Addresses
Primary practice location
261 M 62
Cassopolis, MI 49031-1034
Mailing address
261 M 62
Cassopolis, MI 49031-1034
Phone (269) 445-3874
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111835668 | Medicaid | MI | |
| 1804311-11 | Medicaid | MI | |
| 114156529 | Medicaid | MI | |
| SK008922 | Other | MI | BLUE CROSS BLUE SHIELD |
Other providers in Cassopolis, MI
- Annie Karasch
- Keep Mi Smile Cassopolis PC
- Josslyn Kirkpatrick
- Alison Kozinski
- Breeanna June Skyler Kraft
- Audrea Labadie
- Patricia Laing
- Lakeland Immediate Care Center
- Lakeland Immediate Care Center
- Leslie Lakeman
All providers in Cassopolis, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.