Healthcare Provider Details

I. General information

NPI: 1326158593
Provider Name (Legal Business Name): HIGHGATE MEDICAL GROUP, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6255 SHERIDAN DR STE 200
WILLIAMSVILLE NY
14221-4825
US

IV. Provider business mailing address

6255 SHERIDAN DR STE 200
WILLIAMSVILLE NY
14221-4825
US

V. Phone/Fax

Practice location:
  • Phone: 716-636-7979
  • Fax: 716-929-0192
Mailing address:
  • Phone: 716-636-7979
  • Fax: 716-929-0192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number131001
License Number StateNY

VIII. Authorized Official

Name: DR. DAVID PAWLOWSKI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 716-636-7979