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General NPI Number Information
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NPI Number | 1780020289
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Entity Type | Individual
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Provider Name | SARA WOZNY COULBOURN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/12/2013
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Last Update Date | 06/08/2016
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Provider Practice Location Address
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Address Line | 300 DORCHESTER AVE
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City | CAMBRIDGE
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State | MD
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Zip | 21613-2420
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Country | US
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Telephone | 410-228-2603
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Fax | 410-901-6080
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Provider Business Mailing Address
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Address Line | 300 DORCHESTER AVE
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City | CAMBRIDGE
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State | MD
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Zip | 21613-2420
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Country | US
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Telephone | 410-228-2603
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Fax | 410-901-6080
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MT203656
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D80826
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License Number State | MD
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