Provider Demographics
NPI:1114280377
Name:PAWLOWSKI, NATALIA MARIA (MD)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:MARIA
Last Name:PAWLOWSKI
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:2097 HENRY TECKLENBURG DRIVE
Practice Address - Street 2:SUITE 220 W
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5739
Practice Address - Country:US
Practice Address - Phone:843-571-6868
Practice Address - Fax:843-571-6198
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC83722207Q00000X
CODR.0055458207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC837223Medicaid
CO1114280377OtherMEDICARE