Individual
DR. MICHAEL L NOWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
350 W COUNTRY CLUB RD, STE# 203, ROSWELL, NM 88201-5205
(575) 624-4646
(575) 625-8498
Mailing address
350 W COUNTRY CLUB RD, STE# 203, ROSWELL, NM 88201-5205
(575) 624-4646
(575) 625-8498
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
2619
OH
207V00000X
Obstetrics & Gynecology Physician
Primary
A-1602-11
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000007795
ANTHEM BCBS
OH
05
—
0457349
—
OH
01
—
160029113
RAILROAD MEDICARE PALMETT
OH
01
—
2380630
CIGNA
OH
01
—
310884319026
CARESOURCE
OH
05
—
40004279
—
NM
01
—
4341671
AETNA
OH
01
—
NPI & TIN#
BCBS OF NM
NM
Enumeration date
07/18/2005
Last updated
07/16/2014
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