Provider Demographics
NPI:1528002383
Name:WOWK, VICTOR A (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:A
Last Name:WOWK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1400 FOREST GLEN RD STE 400
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1482
Mailing Address - Country:US
Mailing Address - Phone:301-589-3324
Mailing Address - Fax:301-681-7575
Practice Address - Street 1:1400 FOREST GLEN RD STE 400
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1482
Practice Address - Country:US
Practice Address - Phone:301-589-3324
Practice Address - Fax:301-681-7575
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0032893207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD217911300Medicaid
MDE23219Medicare UPIN