Healthcare Provider Details

I. General information

NPI: 1801065180
Provider Name (Legal Business Name): SEAN MICHAEL OWENS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8118 GOOD LUCK RD
LANHAM MD
20706-3574
US

IV. Provider business mailing address

9704 AVENEL FARM DR
POTOMAC MD
20854-5405
US

V. Phone/Fax

Practice location:
  • Phone: 301-552-8118
  • Fax:
Mailing address:
  • Phone: 719-210-7326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberH67958
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: