Individual
THOMAS S KOWALKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1521 MAPLEWOOD AVE, RONCEVERTE, WV 24970-8026
(304) 647-5642
(304) 647-5708
Mailing address
176 DAWKINS DR, LEWISBURG, WV 24901-9302
(304) 647-4411
(304) 647-5708
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
14532
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0040599000
—
WV
Enumeration date
09/23/2005
Last updated
09/16/2020
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