Healthcare Provider Details

I. General information

NPI: 1295726537
Provider Name (Legal Business Name): OREST BARTOSZYK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 09/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2670 CRAIN HWY SUITE 300
WALDORF MD
20601-2806
US

IV. Provider business mailing address

106 IRVING ST NW SUITE 2700N
WASHINGTON DC
20010-2927
US

V. Phone/Fax

Practice location:
  • Phone: 301-632-5750
  • Fax: 301-632-5755
Mailing address:
  • Phone: 202-877-5800
  • Fax: 202-291-0512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD0039909
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: