Provider Demographics
NPI:1669477923
Name:YANOWITZ, EDWARD STANLEY (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:STANLEY
Last Name:YANOWITZ
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 1:10801 LOCKWOOD DR STE 180
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1559
Mailing Address - Country:US
Mailing Address - Phone:301-587-1127
Mailing Address - Fax:301-587-1129
Practice Address - Street 1:10801 LOCKWOOD DR STE 180
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1559
Practice Address - Country:US
Practice Address - Phone:301-587-1127
Practice Address - Fax:301-587-1129
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0043763207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD277401101Medicaid
A64118Medicare UPIN
MDYA407844Medicare ID - Type Unspecified