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NPI Code Detail

MEDICARE: MADELYN ANN OWCZARZAK KOWAL OD

MEDICARE: MADELYN ANN OWCZARZAK KOWAL OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist4901005873MI

General Provider Information

NPI Number : 1124912027
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELYN ANN OWCZARZAK KOWAL OD
Provider Business Mailing Address
First Line : 2001 COOLIDGE RD
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-1378
Country : US
Telephone Number : 517-337-1668
Fax Number :
Provider Business Practice Location Address
First Line : 2001 COOLIDGE RD
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-1378
Country : US
Telephone Number : 517-337-1668
Fax Number : 517-337-1779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2025
Last Update Date : 12/16/2025

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