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Individual

MICHAEL R TOWARNICKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4275 WESTERN BLVD, JACKSONVILLE, NC 28546-1100
(910) 938-3099
(910) 938-3243
Mailing address
PO BOX 896206, CHARLOTTE, NC 28289-6206
(252) 633-1010
(252) 224-3071

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3598
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
211019D
MEDICARE PTAN
NC
05
7983651
NC
01
83651
BLUE CROSS
NC
Enumeration date
08/30/2005
Last updated
03/17/2017
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