Individual
NICHOLAS BERNARD NOWACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
410 W 10TH AVE, COLUMBUS, OH 43210-1240
(614) 293-5905
(614) 293-4715
Mailing address
700 ACKERMAN RD STE 570, COLUMBUS, OH 43202-1579
(614) 293-9676
(614) 293-7273
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
35127756
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0102511
—
OH
Enumeration date
03/25/2012
Last updated
03/08/2018
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