Individual
MR. BOGDAN LESZEK NOWAKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1429 E. HIGHWAY 30, GONZALES, LA 70737
(225) 647-6900
(844) 766-1659
Mailing address
P.O. BOX 400, BRITTANY, LA 70718-0400
(225) 647-6900
(844) 766-1659
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
12969R
LA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
12969R
LA
207RP1001X
Pulmonary Disease Physician
Primary
12969R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1555100
—
LA
01
—
2215329
AETNA HMO
LA
01
—
48-00155
UCH
—
01
—
7014046
AETNA POS/PPO
LA
01
—
72-1498557001
CIGNA
LA
01
—
G1360
BLU CROSS 5 DIGIT
LA
Enumeration date
09/14/2006
Last updated
06/09/2022
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