MEDICARE: DAVID CARL KOWALSKI M.D.

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	207N00000X	Dermatology Physician	32755	NC

General Provider Information

NPI Number	:	1689760803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID CARL KOWALSKI M.D.

Provider Business Mailing Address
First Line	:	1734 WESTBROOK AVE
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-8721
Country	:	US
Telephone Number	:	336-584-5801
Fax Number	:	336-584-5860

Provider Business Practice Location Address
First Line	:	1734 WESTBROOK AVE
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-8721
Country	:	US
Telephone Number	:	336-584-5801
Fax Number	:	336-584-5860

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	02/28/2024

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