Provider Demographics
NPI:1649321977
Name:MOLS-KOWALCZEWSKI, BARBARA LIDIA (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:LIDIA
Last Name:MOLS-KOWALCZEWSKI
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 1:850 KEMPSVILLE RD STE 100E
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3920
Mailing Address - Country:US
Mailing Address - Phone:757-261-5744
Mailing Address - Fax:757-261-0321
Practice Address - Street 1:850 KEMPSVILLE RD STE 100E
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3920
Practice Address - Country:US
Practice Address - Phone:757-261-5744
Practice Address - Fax:757-261-0321
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101269176207R00000X, 207RE0101X
NY194168207RE0101X
PAMD457936207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01460159Medicaid
NY01460159Medicaid