Provider Demographics
NPI:1710148432
Name:SOWINSKI M.D PC
Entity Type:Organization
Organization Name:SOWINSKI M.D PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAZIMIERZ
Authorized Official - Middle Name:M
Authorized Official - Last Name:SOWINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-552-5545
Mailing Address - Street 1:105 MCDONALD ST
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-3420
Mailing Address - Country:US
Mailing Address - Phone:540-552-5545
Mailing Address - Fax:540-552-5568
Practice Address - Street 1:105 MCDONALD ST
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-3420
Practice Address - Country:US
Practice Address - Phone:540-552-5545
Practice Address - Fax:540-552-5568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101028568261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC10565Medicare PIN