Healthcare Provider Details

I. General information

NPI: 1457278293
Provider Name (Legal Business Name): PHILIP OWENS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 WESEL BLVD
HAGERSTOWN MD
21740-5389
US

IV. Provider business mailing address

502 W KING ST APT 2
MARTINSBURG WV
25401-2645
US

V. Phone/Fax

Practice location:
  • Phone: 301-393-4401
  • Fax:
Mailing address:
  • Phone: 301-465-0534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number02872
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: