Individual
JOHN J. PODKOWA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
208 MILL RD, FAIRHAVEN, MA 02719-5208
(508) 996-1800
(508) 992-7906
Mailing address
200 MILL RD, STE 180, FAIRHAVEN, MA 02719-5252
(508) 973-2000
(508) 973-2001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
239926
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110082851A
—
MA
Enumeration date
04/15/2008
Last updated
04/23/2020
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