Healthcare Provider Details

I. General information

NPI: 1487866174
Provider Name (Legal Business Name): STEPHEN FRANK KOWALSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 CAHABA RD SUITE 310
BIRMINGHAM AL
35223-2623
US

IV. Provider business mailing address

3300 CAHABA RD SUITE 310
BIRMINGHAM AL
35223-2623
US

V. Phone/Fax

Practice location:
  • Phone: 205-423-9440
  • Fax: 205-423-9450
Mailing address:
  • Phone: 205-423-9440
  • Fax: 205-423-9450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number20264
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: