Provider Demographics
NPI:1144630690
Name:KOWAL, EDWARD MARTIN III (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:MARTIN
Last Name:KOWAL
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 RAINFORD RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-1997
Mailing Address - Country:US
Mailing Address - Phone:304-634-2707
Mailing Address - Fax:
Practice Address - Street 1:101 WILLIAM H JOHNSON ST STE 500
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2769
Practice Address - Country:US
Practice Address - Phone:843-777-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC84954207VX0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program