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:
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Health care specialties

SpecialtyCodeLicense #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 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275601437 NPPES
Kentucky Other 000000545011 ANTHEM BCBS
Kentucky MEDICAID 7100037330 ANTHEM BCBS
Kentucky MEDICAID 378003100 ANTHEM BCBS

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