Individual
NATHANIEL NOWACKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 288-4329
(601) 288-3191
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 288-4329
(601) 288-3191
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
26713
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05304297
—
MS
Enumeration date
05/01/2013
Last updated
08/30/2019
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