Individual
DR. TADEUS EDWARD KOWALSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1108 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 793-8087
(334) 793-8191
Mailing address
PO BOX 1928, DOTHAN, AL 36302-1928
(334) 793-8087
(334) 793-8191
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
24492
WV
2084P0800X
Psychiatry Physician
098882
OH
2084P0800X
Psychiatry Physician
Primary
32694
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098882
STATE MEDICAL BOARD
OH
01
—
24492
STATE MEDICAL BOARD
WV
Enumeration date
07/02/2007
Last updated
08/06/2013
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