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General NPI Number Information
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NPI Number | 1669680328
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Entity Type | Individual
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Provider Name | WOJCIECH KRZYSZTOF MYDLARZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 07/22/2015
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Provider Practice Location Address
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Address Line | 6420 ROCKLEDGE DR SUITE 4920
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City | BETHESDA
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State | MD
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Zip | 20817-7837
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Country | US
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Telephone | 301-896-3332
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Fax |
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Provider Business Mailing Address
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Address Line | 6420 ROCKLEDGE DR SUITE 4920
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City | BETHESDA
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State | MD
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Zip | 20817-7837
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Country | US
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Telephone | 301-896-3332
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | D0068013
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | P8515
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License Number State | TX
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