Doctor Name: | MR. DAVID MICHAEL KORKOWSKI |
NPI Number: | 1710311659 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MLT (ASCP) |
License Number: | |
Business Practice Address: | 107 H Street East Poplar, MT - 592550067 |
Business Phone Number: | 4067683491 |
Business Fax Number: | 4067683435 |
Mailing Address: | 107 H Street East, POPLAR |
State: | MT |
Postal Code: | 592550067 |
Phone Number: | 4067683491 |
Fax Number: | 4067683435 |
NPI Enumeration Date: | 08/28/2013 |
NPI Last Update Date: | 08/28/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 247ZC0005X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Pathology |
Taxonomy Specialization: | Clinical Laboratory Director, Non-physician |
Taxonomy Definition: | An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. |