Provider Demographics
NPI:1508843632
Name:NOWICK, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:NOWICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:455 SHERMAN ST
Mailing Address - Street 2:STE 510
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-4400
Mailing Address - Country:US
Mailing Address - Phone:303-377-6825
Mailing Address - Fax:303-780-0787
Practice Address - Street 1:455 SHERMAN
Practice Address - Street 2:SUITE 510
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-4405
Practice Address - Country:US
Practice Address - Phone:303-377-6825
Practice Address - Fax:303-780-0787
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2021-01-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO39257207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY117701000Medicaid
NE84113438513Medicaid
MT3506685Medicaid
NM21570728Medicaid
KS100428890AMedicaid
CO87978717Medicaid
COH32893Medicare UPIN
MT3506685Medicaid
COCOA107898Medicare PIN