Individual
EDMUND NOWICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
196 ARROWHEAD DR, STE 1, EVANSTON, WY 82930-8752
(877) 892-9701
Mailing address
7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2829
(615) 465-7000
(615) 309-3338
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6193A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113930400
—
WY
01
—
308483
BCBS
WY
Enumeration date
06/16/2005
Last updated
02/27/2008
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