Individual
MICHAEL NOWACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2307 GREENE WAY, LOUISVILLE, KY 40220-4009
(502) 897-9594
(502) 896-1808
Mailing address
2307 GREENE WAY, LOUISVILLE, KY 40220-4009
(502) 736-4343
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
38687
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200486840
—
IN
05
—
64084213
—
KY
Enumeration date
05/31/2005
Last updated
09/12/2016
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