Basic Information
| Provider Information | |||||||||
| NPI: | 1831354570 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | KOWALSKA | ||||||||
| FirstName: | AGNIESZKA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 HOSPITAL DR RM CE509 | ||||||||
| Address2: | DEPARTMENT OF NEUROLOGY | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652120001 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 5 HOSPITAL DR RM CE509 | ||||||||
| Address2: | DEPARTMENT OF NEUROLOGY | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652120001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738822260 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2008 | ||||||||
| LastUpdateDate: | 07/22/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 2008010944 | MO | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.