Provider Demographics
NPI:1205221314
Name:WOZNICA, EDGAR (MD)
Entity Type:Individual
Prefix:
First Name:EDGAR
Middle Name:
Last Name:WOZNICA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N WOLFE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0005
Mailing Address - Country:US
Mailing Address - Phone:630-414-1950
Mailing Address - Fax:
Practice Address - Street 1:COMMUNITY CORRECTIONAL FACILITIES
Practice Address - Street 2:1901 D ST SE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003
Practice Address - Country:US
Practice Address - Phone:202-698-0400
Practice Address - Fax:202-547-1497
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD72942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry