Healthcare Provider Details

I. General information

NPI: 1447229968
Provider Name (Legal Business Name): LOUIS Y KORMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 02/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5530 WISCONSIN AVE SUITE 802
CHEVY CHASE MD
20815-4404
US

IV. Provider business mailing address

5550 FRIENDSHIP BLVD T-90
CHEVY CHASE MD
20815-7256
US

V. Phone/Fax

Practice location:
  • Phone: 301-654-2521
  • Fax: 301-654-2986
Mailing address:
  • Phone: 301-654-2521
  • Fax: 301-654-2986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberD0022154
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: