Individual provider · NPI-1

Jaroslaw M Ambroziak, MD

Family Medicine · Columbia, SC

NPI number1477506459
StatusActive
Last updated in NPPESJul 12, 2010

Details

NPI
1477506459
Entity type
Individual (NPI-1)
Name
Jaroslaw M Ambroziak
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
May 18, 2006
Last updated
Jul 12, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine21987SCYes

Other names

  • Jeremy M Ambroziak (Other Name)

Practice location

2750 Laurel St
103
Columbia, SC 29204-2038

Phone 803-254-5171 · Fax 803-779-7403

Mailing address

2750 Laurel St
103
Columbia, SC 29204-2023

Phone 803-254-5171 · Fax 803-779-7403

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