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NPI Code Detail

MEDICARE: DR. ANNE M PAWLAK D.O.

MEDICARE: DR. ANNE M PAWLAK D.O.
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
12084N0400XNeurology PhysicianAP007664MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891784484
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANNE M PAWLAK D.O.
Provider Business Mailing Address
First Line : 1105 SIXTH ST
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-2345
Country : US
Telephone Number : 231-935-5000
Fax Number :
Provider Business Practice Location Address
First Line : 3922 CEDAR RUN RD
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-9687
Country : US
Telephone Number : 231-392-0430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2005
Last Update Date : 11/20/2025

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