MEDICARE: MR. EDWARD MICHAEL NOWAK DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	266	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00172510	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	Y35048	OTHER		BLUE SHIELD OF MA
4	0004361700	OTHER		AETNA
5	798574	OTHER		TUFTS
6	351055	OTHER	MA	HARVARD PILGRIM

General Provider Information

NPI Number	:	1184601676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EDWARD MICHAEL NOWAK DC

Provider Business Mailing Address
First Line	:	PO BOX 337
Second Line	:
City	:	HADLEY
State	:	MA
Zip	:	01035-0337
Country	:	US
Telephone Number	:	413-584-8976
Fax Number	:	413-584-7354

Provider Business Practice Location Address
First Line	:	190 RUSSELL STREET
Second Line	:
City	:	HADLEY
State	:	MA
Zip	:	01035-9542
Country	:	US
Telephone Number	:	413-584-8976
Fax Number	:	413-584-7354

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	07/06/2012

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Directions to “ MR. EDWARD MICHAEL NOWAK DC” Practice Location

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