Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | C1-0013700 | DE |
N | 111NI0900X | Internist | C1-0013700 | DE |
N | 207R00000X | Internist | MT187544 | PA |
N | 111NI0900X | Internist | MT187544 | PA |
N | 207SG0201X | Clinical Genetics (M.D.) | 046150 | CT |
Y | 207SG0201X | Clinical Genetics (M.D.) | C1-0013700 | DE |
NPI | 1659586352 |
---|---|
Provider Name | Pawel T Pomianowski |
First Address | Newark, DE 19713-7000 |
Second Address | Newark, DE 19713-7000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 24/08/2020 |