Provider Demographics
NPI:1770799447
Name:WOLOV, KEVIN RANDALL (DO)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:RANDALL
Last Name:WOLOV
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:621 RIDGELY AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1081
Mailing Address - Country:US
Mailing Address - Phone:410-224-4887
Mailing Address - Fax:410-224-1428
Practice Address - Street 1:621 RIDGELY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1081
Practice Address - Country:US
Practice Address - Phone:410-224-4887
Practice Address - Fax:410-224-1428
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2015-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDH0070814207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology