Basic Information
Provider Information
NPI: 1114905908
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HIRSZEL
FirstName: PRZEMYSLAW
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5819 GROSVENOR LN
Address2:  
City: BETHESDA
State: MD
PostalCode: 208141835
CountryCode: US
TelephoneNumber: 3012953602
FaxNumber: 3012953557
Practice Location
Address1: 8901 WISCONSIN AVE
Address2: NNMC
City: BETHESDA
State: MD
PostalCode: 208890001
CountryCode: US
TelephoneNumber: 3012954330
FaxNumber: 3012956081
Other Information
ProviderEnumerationDate: 01/03/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300XD28953MDY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


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