Provider Demographics
NPI:1215033410
Name:WOZNIAK, MARCELLA A (MD)
Entity Type:Individual
Prefix:
First Name:MARCELLA
Middle Name:A
Last Name:WOZNIAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 S. EUTAW STREET
Mailing Address - Street 2:FRENKIL BLDG. 3RD FL.
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201
Mailing Address - Country:US
Mailing Address - Phone:410-328-4323
Mailing Address - Fax:410-328-1149
Practice Address - Street 1:16 S. EUTAW STREET
Practice Address - Street 2:FRENKIL BLDG. 3RD FL.
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201
Practice Address - Country:US
Practice Address - Phone:410-328-4323
Practice Address - Fax:410-328-1149
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD434842084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF72784Medicare UPIN