Gonwa, Mark
Gonwa, Mark is an individual health care provider with primary practice located at 1500 N Dixie Hway Ste 306, West Palm Beach FL 33401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Gonwa, Mark can be contacted via phone (561) 837-4834.Contact Information
Primary practice address
1500 N Dixie Hway Ste 306
West Palm Beach FL 33401
Phone: (561) 837-4834
Fax: (561) 837-2225
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME64311 | Florida |
Profile Details
NPI number | 1275601437 |
---|---|
LBN Legal business name | Gonwa, Mark |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 4th, 2006 |
Last updated | Mar 7th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1275601437 | NPPES |
Kentucky | Other | 000000545011 | ANTHEM BCBS |
Kentucky | MEDICAID | 7100037330 | ANTHEM BCBS |
Kentucky | MEDICAID | 378003100 | ANTHEM BCBS |
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