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Individual

DR. THOMAS E KOWALSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
21 BARKLEY CIRCLE, FORT MYERS, FL 33907
(239) 939-2616
(239) 939-9093
Mailing address
2234 COLONIAL BLVD, MANAGED CARE DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME0048210
FL
2086S0129X
Vascular Surgery Physician
ME0048210
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
044255100
FL
01
1114981
CIGNA PROVIDER #
FL
01
205689
AMERIGROUP
01
206369
AVMED
01
36427
BCBS PROVIDER #
FL
01
4109759
AETNA PROVIDER #
FL
01
974397
WELLCARE
FL
Enumeration date
04/18/2006
Last updated
03/21/2017
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