Provider Demographics
NPI:1801894696
Name:NOWAK, MIHAELA MIHAESCU (MD)
Entity type:Individual
Prefix:DR
First Name:MIHAELA
Middle Name:MIHAESCU
Last Name:NOWAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:575 COAL VALLEY RD STE 464
Mailing Address - Street 2:
Mailing Address - City:CLAIRTON
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3740
Mailing Address - Country:US
Mailing Address - Phone:412-267-6360
Mailing Address - Fax:412-267-6361
Practice Address - Street 1:575 COAL VALLEY RD STE 464
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-3740
Practice Address - Country:US
Practice Address - Phone:412-267-6360
Practice Address - Fax:412-267-6361
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072976L2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
11809804OtherCAQH
PA001975702Medicaid
MI1550488OtherBS
PA0019757020001Medicaid
H98123Medicare UPIN
MI1550488OtherBS