Individual
DR. MARK KOWALSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-1000
Mailing address
2100 POWELL ST, SUITE 920, EMERYVILLE, CA 94608-1826
(510) 350-2777
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
114693
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538116835
—
MO
05
—
244748927
—
MO
01
—
P00691432
RR MEDICARE
—
Enumeration date
05/30/2006
Last updated
09/08/2015
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