Provider Demographics
NPI:1619952686
Name:KOWALSKI, MAGDALENA U (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGDALENA
Middle Name:U
Last Name:KOWALSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 BATTLEFIELD PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-5166
Mailing Address - Country:US
Mailing Address - Phone:706-861-4990
Mailing Address - Fax:706-861-9405
Practice Address - Street 1:4700 BATTLEFIELD PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-5166
Practice Address - Country:US
Practice Address - Phone:706-861-4990
Practice Address - Fax:706-861-9405
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA49047207Q00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA397669397AMedicaid
TN3855675Medicare ID - Type Unspecified
GA08BBQQVMedicare ID - Type Unspecified