Individual
DEBORAH M. NOWAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6565 FRANCE AVE S STE 350, EDINA, MN 55435
(612) 389-1093
Mailing address
11407 CREEKRIDGE DR, EDEN PRAIRIE, MN 55347-4311
(952) 836-8513
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
48182
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096028400
—
MN
Enumeration date
07/04/2006
Last updated
06/21/2019
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