Basic Information
| Provider Information | |||||||||
| NPI: | 1235557208 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAWLOWSKI | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 IRVING ST NW STE 2A38M | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200103017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028770393 | ||||||||
| FaxNumber: | 2028777973 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 IRVING ST NW STE 2A38M | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200103017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028770393 | ||||||||
| FaxNumber: | 2028777973 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2014 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A138344 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD045159 | DC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | JP3232267556 | 05 | CA | MEDICAID |