Provider Demographics
NPI:1962485318
Name:PAWLOWSKI, DAVID E (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:PAWLOWSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2041 E SQUARE LAKE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-3897
Mailing Address - Country:US
Mailing Address - Phone:248-813-0124
Mailing Address - Fax:248-879-0148
Practice Address - Street 1:2041 E SQUARE LAKE RD STE 300
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-3897
Practice Address - Country:US
Practice Address - Phone:248-813-0124
Practice Address - Fax:248-879-0148
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2019-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101010038207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2573863Medicaid
MI2573863Medicaid
E85740Medicare UPIN