Individual
JOSEPH GAWLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
919 MAIN ST STE 101, DYER, IN 46311-3717
(219) 836-7531
(219) 836-7593
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
10004646A
IN
363A00000X
Physician Assistant
Primary
10004646A
IN
363AM0700X
Medical Physician Assistant
085.009464
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085-009464
LICENSE
IL
Enumeration date
06/04/2021
Last updated
05/19/2025
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