Individual
NICHOLAS PETER KONOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-1553
Mailing address
10625 W NORTH AVE STE 101B, WAUWATOSA, WI 53226-2315
(414) 727-9183
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
8154120
WI
207R00000X
Internal Medicine Physician
8154120
WI
208D00000X
General Practice Physician
4301507842
MI
208M00000X
Hospitalist Physician
81541
WI
Other
Enumeration date
04/24/2018
Last updated
08/16/2023
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