Provider Demographics
NPI:1003298720
Name:NOWALK, NATHAN CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:CHARLES
Last Name:NOWALK
Suffix:
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 1:3624 MARKET ST STE 205
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2616
Mailing Address - Country:US
Mailing Address - Phone:215-349-5477
Mailing Address - Fax:
Practice Address - Street 1:3624 MARKET ST STE 201
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2614
Practice Address - Country:US
Practice Address - Phone:215-662-7772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD490543207RS0012X
IL036152140207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine