Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 073800 | GA |
N | 207X00000X | Orthopaedic Surgeon | 241059 | MA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | Q0092 | TX |
NPI | 1245466036 |
---|---|
Provider Name | Dr. Deborah Ann Kowalchuk |
First Address | Johns Creek, GA 30097-1549 |
Second Address | Johns Creek, GA 30097-1549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2009 |
Last Update Date | 17/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003168359A | (05) | GA |