Healthcare Provider Details

I. General information

NPI: 1154761898
Provider Name (Legal Business Name): CHRISTOPHER EDWARD KOWALSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2013
Last Update Date: 12/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3841 PIPER ST. SUITE T-230
ANCHORAGE AK
99508
US

IV. Provider business mailing address

3841 PIPER ST. SUITE T-230
ANCHORAGE AK
99508
US

V. Phone/Fax

Practice location:
  • Phone: 907-279-8800
  • Fax: 907-279-8810
Mailing address:
  • Phone: 907-279-8800
  • Fax: 907-279-8810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number138336
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: