Provider Demographics
NPI:1366513046
Name:MALINOWSKI, VOITEK (PT)
Entity type:Individual
Prefix:
First Name:VOITEK
Middle Name:
Last Name:MALINOWSKI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31150 HOOVER RD
Mailing Address - Street 2:STE C
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-7618
Mailing Address - Country:US
Mailing Address - Phone:586-268-1929
Mailing Address - Fax:586-268-1933
Practice Address - Street 1:31150 HOOVER RD
Practice Address - Street 2:STE C
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-7618
Practice Address - Country:US
Practice Address - Phone:586-268-1929
Practice Address - Fax:586-268-1933
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501006064225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI650E19970OtherBCBS
MI650E19970OtherBCBS