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General NPI Number Information
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NPI Number | 1659476265
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Entity Type | Individual
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Provider Name | BOGDAN LESZEK NOWAKOWSKI MD
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 1429 E. HIGHWAY 30
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City | GONZALES
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State | LA
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Zip | 70737
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Country | US
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Telephone | 225-647-6900
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Fax | 844-766-1659
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Provider Business Mailing Address
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Address Line | P.O. BOX 400
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City | BRITTANY
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State | LA
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Zip | 70718-0400
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Country | US
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Telephone | 225-647-6900
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Fax | 844-766-1659
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 12969R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 12969R
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 12969R
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License Number State | LA
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