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27 Parsons Lane, Fayetteville, WV 25840-0957 | |
(304) 574-2310 | |
(304) 574-2311 |
Full Name | |
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Type | Facility |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 27 Parsons Lane, Fayetteville, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184667396 | NPI | - | NPPES |
001721892 | Other | WV | MOUNTAIN STATE BC BS |
0099788000 | Medicaid | WV | |
DD8123 | Other | WV | RAILROAD MEDICARE |
223203 | Other | WV | CARELINK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 00282 (West Virginia) | Secondary |
213ES0103X | Podiatrist - Foot & Ankle Surgery | 00282 (West Virginia) | Primary |
Provider Name | Martin Matthew Mrozek |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1437119856 PECOS PAC ID: 2163463027 Enrollment ID: I20050524000784 |
Mailing Address | Practice Location Address |
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Po Box 825159 Department C, Philadelphia, PA 19182-5159 Ph: (304) 574-2310 | 27 Parsons Lane, Fayetteville, WV 25840-0957 Ph: (304) 574-2310 |
Dr. Martin M Mrozek, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 27 Parsons Lane, Fayetteville, WV 25840 Phone: 304-574-2310 Fax: 304-574-2311 |