Individual
MARY CAROLINE MIKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
RT 50 WEST, SALEM, WV 26426
(304) 782-2000
(304) 782-3102
Mailing address
PO BOX 392, SALEM, WV 26426-0392
(304) 782-2000
(304) 782-3102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17990
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0054670000
—
WV
Enumeration date
09/21/2006
Last updated
02/22/2010
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