Healthcare Provider Details

I. General information

NPI: 1487449005
Provider Name (Legal Business Name): ALLISON KOWALSKI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 BIDDLE AVE
WYANDOTTE MI
48192-4668
US

IV. Provider business mailing address

2333 BIDDLE AVE
WYANDOTTE MI
48192-4668
US

V. Phone/Fax

Practice location:
  • Phone: 734-246-7086
  • Fax:
Mailing address:
  • Phone: 734-246-7086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number5151017178
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: