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NPI Code Detail

MEDICARE: RONALD PAWLAK MD

MEDICARE: RONALD PAWLAK MD
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
1207Q00000XFamily Medicine Physician0101266324VA

General Provider Information

NPI Number : 1811346349
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONALD PAWLAK MD
Provider Business Mailing Address
First Line : 104 CAROLINA AVE
Second Line :
City : BROOKNEAL
State : VA
Zip : 24528-2643
Country : US
Telephone Number : 434-376-2325
Fax Number : 434-376-2081
Provider Business Practice Location Address
First Line : 104 CAROLINA AVE
Second Line :
City : BROOKNEAL
State : VA
Zip : 24528-2643
Country : US
Telephone Number : 434-376-2325
Fax Number : 434-376-2081
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2016
Last Update Date : 06/30/2019

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