Healthcare Provider Details

I. General information

NPI: 1508836644
Provider Name (Legal Business Name): CHRISTOPHER JOHN KOWALSKY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 10/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NATIONAL NAVAL MEDICAL CENTER 8901 WISCONSIN AVE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

15005 SNOWDEN DR
SILVER SPRING MD
20905-5662
US

V. Phone/Fax

Practice location:
  • Phone: 301-922-0547
  • Fax:
Mailing address:
  • Phone: 301-879-8019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberD0063665
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: