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Individual

DR. ANDRE J NOLEWAJKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD; M.CL.SC

Contact information

Practice address
7001 ROGERS AVE, STE 401, FORT SMITH, AR 72903-4073
(479) 314-4650
(479) 452-9459
Mailing address
PO BOX 10570, FORT SMITH, AR 72917-0570
(479) 314-4650
(479) 452-9459

Taxonomy

Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
R2997
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100078200A
OK
05
105850001
AR
01
119173
DEPT OF LABOR
01
14059000040
QUALCHOICE
01
29730300
BLACK LUNG
01
53875
MEDICARE, ARK BC, FED BC
01
60014634
TRAVELERS M/C R/R
01
A002
TRICARE
Enumeration date
06/13/2005
Last updated
07/01/2013
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