Provider Demographics
NPI:1235136003
Name:GAWRONSKI, DARIUSZ WALDEMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:DARIUSZ
Middle Name:WALDEMAR
Last Name:GAWRONSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 PARK ROWE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1685
Mailing Address - Country:US
Mailing Address - Phone:225-769-2200
Mailing Address - Fax:225-768-2185
Practice Address - Street 1:10101 PARK ROWE AVE STE 200
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1685
Practice Address - Country:US
Practice Address - Phone:225-769-2200
Practice Address - Fax:225-768-2185
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.2035112084N0400X
NV111872084N0400X
MN502472084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1235136003OtherAMERICA'S PPO
MN6I303GAOtherBCBS
WI34949700Medicaid
MN1052916OtherPREFERRED ONE
MNHP84390OtherHEALTHPARTNERS
MN0500991OtherMEDICA
MN139870C029OtherUCARE
MN540063000Medicaid
MN130001352Medicare PIN
WI34949700Medicaid