Provider Demographics
NPI:1447511811
Name:CHOROMANSKA, AGNIESZKA DAGMARA (MD)
Entity type:Individual
Prefix:MRS
First Name:AGNIESZKA
Middle Name:DAGMARA
Last Name:CHOROMANSKA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3601 W 13 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6712
Mailing Address - Country:US
Mailing Address - Phone:248-898-6091
Mailing Address - Fax:248-898-2496
Practice Address - Street 1:3601 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6712
Practice Address - Country:US
Practice Address - Phone:248-898-6091
Practice Address - Fax:248-898-2496
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2016-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43011005562085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology