Provider Demographics
NPI:1346497732
Name:MARK L. BILOWUS, M.D. PC
Entity Type:Organization
Organization Name:MARK L. BILOWUS, M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BILOWUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-478-0260
Mailing Address - Street 1:1850 TOWN CENTER PKWY STE 409
Mailing Address - Street 2:MEDICAL PAVILION
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3232
Mailing Address - Country:US
Mailing Address - Phone:703-478-0260
Mailing Address - Fax:703-478-2718
Practice Address - Street 1:1850 TOWN CENTER PKWY STE 409
Practice Address - Street 2:MEDICAL PAVILION
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3232
Practice Address - Country:US
Practice Address - Phone:703-478-0260
Practice Address - Fax:703-478-2718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101038025208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C62085Medicare UPIN