Individual
CHARLES S NOWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2020 N 12TH ST, GRAND JUNCTION, CO 81501-2914
(970) 644-4220
(970) 263-4239
Mailing address
PO BOX 1727, GRAND JUNCTION, CO 81502-1727
(970) 263-2600
(970) 263-2692
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
CO 48799
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01555022
—
CO
Enumeration date
11/03/2005
Last updated
06/28/2022
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