Basic Information
Provider Information
NPI: 1629272117
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KORZYNIOWSKI
FirstName: ANDREW
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1869
Address2:  
City: FLETCHER
State: NC
PostalCode: 287321869
CountryCode: US
TelephoneNumber: 8286875616
FaxNumber: 8286508076
Practice Location
Address1: 100 HOSPITAL DR
Address2:  
City: HENDERSONVILLE
State: NC
PostalCode: 287925272
CountryCode: US
TelephoneNumber: 8286812420
FaxNumber: 8286870729
Other Information
ProviderEnumerationDate: 06/11/2007
LastUpdateDate: 07/26/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X45293TNN Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000X201301633NCY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
P0130368101NCRAILROAD MEDICAREOTHER


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