Individual
TIMOTHY KWIATKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
566 RUIN CREEK RD, EMERGENCY DEPARTMENT, HENDERSON, NC 27536-2927
(252) 436-1162
(919) 425-0478
Mailing address
3114 CROASDAILE DR, SUITE 200, DURHAM, NC 27705-2508
(919) 425-1565
(919) 425-0478
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9701443
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8911908
—
NC
Enumeration date
10/04/2005
Last updated
08/17/2010
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