Provider Demographics
NPI:1992393813
Name:PAWLOWSKI, GEOFFREY (CP)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:
Last Name:PAWLOWSKI
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7554 GRAND BLVD # SR51
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-6672
Mailing Address - Country:US
Mailing Address - Phone:219-942-2148
Mailing Address - Fax:
Practice Address - Street 1:7554 GRAND BLVD # SR51
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6672
Practice Address - Country:US
Practice Address - Phone:219-942-2148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist