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General NPI Number Information
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NPI Number | 1083670244
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Entity Type | Individual
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Provider Name | JAMES R PAWLAK M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 1703 N TAYLOR DR
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City | SHEBOYGAN
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State | WI
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Zip | 53081-1933
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Country | US
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Telephone | 920-457-4438
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Fax | 920-457-6748
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Provider Business Mailing Address
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Address Line | FROEDTERT & MCW SHEBOYGAN TAYLOR CLINIC 1414 N. TAYLOR DR.
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City | SHEBOYGAN
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State | WI
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Zip | 53081
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Country | US
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Telephone | 920-476-6300
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Fax | 920-476-6301
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20830-020
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License Number State | WI
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