Healthcare Provider Details

I. General information

NPI: 1497979843
Provider Name (Legal Business Name): ALLEN AVINOAM KOWARSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 NICHOLSON LN SUITE 1135
ROCKVILLE MD
20852-5719
US

IV. Provider business mailing address

5801 NICHOLSON LN SUITE 1135
ROCKVILLE MD
20852-5719
US

V. Phone/Fax

Practice location:
  • Phone: 301-816-0644
  • Fax: 301-816-0644
Mailing address:
  • Phone: 301-816-0644
  • Fax: 301-816-0644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberD0002434
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: