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Individual

RONALD JOSEPH NOWAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
13734 E 12 MILE RD, WARREN, MI 48088-3751
(586) 773-8260
(586) 773-7940
Mailing address
13734 E 12 MILE RD, WARREN, MI 48088-3751
(586) 773-8260
(586) 773-7940

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
540E00825
BLUE CROSS BLUE SHIELD
MI
Enumeration date
01/30/2007
Last updated
01/25/2008
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