TIMOTHY KOWALESKI (NPI# 1083093272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083093272 |
| Entity Type | Individual |
| Full Name | TIMOTHY KOWALESKI |
| Credential | DO |
| Practice Address |
1818 Carew St Ste 230 Fort Wayne IN 46805-4764 |
| Mailing Address |
3702 New Vision Dr Bldg B Fort Wayne IN 46845-1703 |
| Practice Telephone | 2603738000 |
| Practice Fax Number | 2603738034 |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2020-07-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 02004981A | IN | Allopathic & Osteopathic Physicians |
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
02004981A | IN | Allopathic & Osteopathic Physicians |
| Street Address |
1818 CAREW ST STE 230 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-4764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790762078 | Alycia Brown | Psychiatry & Neurology | 1818 Carew St Ste 230, Fort Wayne, IN 46805-4764 | 2005-12-28 |
| 1942851795 | Carrie Meyer | Physician Assistant | 1818 Carew St Ste 230, Fort Wayne, IN 46805-4764 | 2019-09-24 |
| 1932614500 | Brian M. Keske | Physician Assistant | 1818 Carew St Ste 230, Fort Wayne, IN 46805-4764 | 2017-12-05 |
| 1619377280 | Vinita Prasad | Psychiatry & Neurology | 1818 Carew St Ste 230, Fort Wayne, IN 46805 | 2014-09-02 |
| 1902924665 | Tamika Janell Houghton | Psychiatry & Neurology | 1818 Carew St Ste 230, Fort Wayne, IN 46805-4764 | 2007-03-27 |
| 1760458921 | Ahsan Mahmood | Psychiatry & Neurology | 1818 Carew St Ste 230, Fort Wayne, IN 46805-4764 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
| 1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
| 1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
| 1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
| 1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
| 1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
| 1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
| 1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
| Find all providers in zip 46805 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457551103 | Medical Clinic of Greensburg | Internal Medicine | 203 East North Street, Greesnburg, IN 46240 | 2007-07-20 |
| 1215082813 | Steven E Stoller | Internal Medicine | 1528 Nw 5th St, Suite 100, Richmond, IN 47374-1844 | 2007-01-24 |
| 1265708168 | Shane Jacob Kibbe | Internal Medicine | 1220 Spring St, Jeffersonville, IN 47130-3704 | 2012-03-26 |
| 1104140664 | Adam Scott Lenet | Internal Medicine | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2010-03-26 |
| 1215124474 | William E Washington Jr Md P C | Internal Medicine | 4844 Broadway, Gary, IN 46408-4509 | 2007-10-01 |
| 1053439489 | John Robert Colaluca | Internal Medicine | 898 E Main St, Greenwood, IN 46143-1407 | 2007-03-26 |
| 1740385525 | Rebecca H Kelly | Internal Medicine | 7250 Clearvista Dr, Suite 327a, Indianapolis, IN 46256-4692 | 2006-09-14 |
| 1619072493 | Fairbanks Hospital, Inc. | Internal Medicine | 8102 Clearvista Pkwy, Indianapolis, IN 46256-1661 | 2006-09-14 |
| 1730122268 | Michael Seth Miller | Internal Medicine | 8355 Rockville Rd Ste 120, Indianapolis, IN 46234-2722 | 2006-06-13 |
| City | FORT WAYNE |
| Zip Code | 46805 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.