Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 04-29238 | KS |
NPI | 1003916651 |
---|---|
Provider Name | William J Nowack |
First Address | Brentwood, TN 37027-5780 |
Second Address | Leawood, KS 66209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2006 |
Last Update Date | 20/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100398080A | (05) | KS |
130023644 | RAILROAD MEDICARE (01) | |
205367808 | (05) | MO |
29664013 | BCBS KANSAS CITY (01) | MO |
411340 | FIRSTGUARD (01) | KS |
B28312 | (02) |