Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 01056660 | IN |
NPI | 1023018546 |
---|---|
Provider Name | Edward J Krowiak |
First Address | Carmel, IN 46032-4578 |
Second Address | Carmel, IN 46032-4578 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2005 |
Last Update Date | 23/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200418830 | (05) | IN |
G99570 | (02) | IN |