Provider Demographics
NPI:1760690416
Name:KOWAL, DANIEL JONATHAN (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JONATHAN
Last Name:KOWAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1045
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01613-1045
Mailing Address - Country:US
Mailing Address - Phone:978-939-2035
Mailing Address - Fax:978-939-2039
Practice Address - Street 1:14 RICE RD
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:MA
Practice Address - Zip Code:01468-1332
Practice Address - Country:US
Practice Address - Phone:978-939-2035
Practice Address - Fax:978-939-2039
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2010-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2316892085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
042477296OtherHEALTH CARE VALUE MANAGEMENT
MA1760690416OtherAETNA
MA042477296OtherPRIVATE HEALTH CARE SYSTEM
MAJ41439OtherBLUE CROSS AND BLUE SHIELD
MA2137364Medicaid
MAAA121577OtherHARVARD PILGRIM HEALTH CARE
MA042477296OtherUNITED HEALTH CARE
MA1760690416OtherFALLON COMMUNITY HEALTH PLAN
MA1760690416OtherCIGNA
MA1760690416OtherAETNA