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Individual

MICHAEL J NOWAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1932 ALCOA HWY STE 270, KNOXVILLE, TN 37920-1537
(865) 251-4658
(865) 251-4659
Mailing address
1932 ALCOA HWY, STE 270, KNOXVILLE, TN 37920-1537
(865) 251-4658
(865) 251-4659

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10410
MN
363A00000X
Physician Assistant
Primary
3305
TN
363AS0400X
Surgical Physician Assistant
1692
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41984300
WI
05
ENROLLED
MN
Enumeration date
06/13/2005
Last updated
02/13/2018
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