Individual Professional Information |
|
NPI
|
1386839512
|
|
Unique healthcare provider (clinician) ID assigned by NPPES
|
|
PECOS UID
|
7113007865
|
|
Unique individual clinician ID assigned by PECOS
|
|
Professional Enrollment ID
|
I20080222000063
|
|
Unique ID for the individual professional enrollment that is the source for the data in the observation
|
|
Provider Last Name
|
KOWALYK
|
|
Individual professional last name
|
|
Provider First Name
|
TEON
|
|
Individual professional first name
|
|
Provider Gender
|
M
|
|
The provider's gender if the provider is a person.
|