Provider Demographics
NPI:1598930364
Name:D.A.W. WILKOWSKI, MD
Entity Type:Organization
Organization Name:D.A.W. WILKOWSKI, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH ANN
Authorized Official - Middle Name:W
Authorized Official - Last Name:WILKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-897-0409
Mailing Address - Street 1:229 LYMAN HALL
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-1048
Mailing Address - Country:US
Mailing Address - Phone:912-897-0409
Mailing Address - Fax:912-897-3886
Practice Address - Street 1:13040 ABERCORN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-1955
Practice Address - Country:US
Practice Address - Phone:912-897-0409
Practice Address - Fax:912-897-3886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048743207L00000X
GARN135422367500000X
GA004917367H00000X
GA2336367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist AssistantGroup - Multi-Specialty