Kowalczyk, Wallace
Kowalczyk, Wallace is an individual health care provider with primary practice located at 5401 Old Court Rd , Randallstown MD 21133-5103. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Kowalczyk, Wallace can be contacted via phone (410) 521-2200.Contact Information
Primary practice address
5401 Old Court Rd
Randallstown MD 21133-5103
Phone: (410) 521-2200
Fax: (410) 655-7190
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | D0016741 | Maryland |
Profile Details
| NPI number | 1720173875 |
|---|---|
| LBN Legal business name | Kowalczyk, Wallace |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 4th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720173875 | NPPES |
| Maryland | Other | 454MH696 | TRAILBLAZER |
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