Healthcare Provider Details

I. General information

NPI: 1124169776
Provider Name (Legal Business Name): ANNE KOWALSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9094 E MINERAL CIR SUITE 100
CENTENNIAL CO
80112-7200
US

IV. Provider business mailing address

1478 S CLAYTON ST
DENVER CO
80210-2415
US

V. Phone/Fax

Practice location:
  • Phone: 303-694-3200
  • Fax:
Mailing address:
  • Phone: 303-694-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35163
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: