Healthcare Provider Details
I. General information
NPI: 1053594622
Provider Name (Legal Business Name): LOUIS KOZLOFF, M.D. & HUGH TROUT, M.D.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/06/2007
Last Update Date: 03/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8218 WISCONSIN AVE SUITE 204
BETHESDA MD
20814-3107
US
IV. Provider business mailing address
8218 WISCONSIN AVE SUITE 204
BETHESDA MD
20814-3107
US
V. Phone/Fax
- Phone: 301-652-1209
- Fax: 301-951-8425
- Phone: 301-652-1209
- Fax: 301-951-8425
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
BETSY
FARMER
Title or Position: OFFICE MANAGER
Credential:
Phone: 301-652-1209