Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 84954 | SC |
NPI | 1144630690 |
---|---|
Provider Name | Dr. Edward Martin Kowal III |
First Address | Florence, SC 29501-1997 |
Second Address | Florence, SC 29506-2769 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2014 |
Last Update Date | 02/04/2021 |