Healthcare Provider Details

I. General information

NPI: 1346281003
Provider Name (Legal Business Name): LOUIS A KOWALSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 01/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

276 NEWPORT RD SUITE 108
NEW LONDON NH
03257-5468
US

IV. Provider business mailing address

276 NEWPORT RD SUITE 108
NEW LONDON NH
03257-5468
US

V. Phone/Fax

Practice location:
  • Phone: 603-526-6929
  • Fax: 603-526-2296
Mailing address:
  • Phone: 603-526-6929
  • Fax: 603-526-2296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number7651
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: