Individual
SUZANNE MARY NOWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2 COLUMBIA DR, SUITE A327, TAMPA, FL 33606-3508
(813) 844-4396
(813) 844-4972
Mailing address
PO BOX 244, SHELBY, MI 49455-0244
(231) 861-6876
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME67866
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42387
BCBS
FL
01
—
42387X
GTBA MEDICARE REASSIGN
FL
01
—
7187513
AETNA
FL
01
—
P00399335
MEDICARE RAILROAD
FL
Enumeration date
07/10/2006
Last updated
03/27/2008
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