MARC LYLE KOZAM (NPI# 1821074014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821074014 |
| Entity Type | Individual |
| Full Name | MARC LYLE KOZAM |
| Credential | MD |
| Practice Address |
18111 Prince Philip Dr Suite T-14 Olney MD 20832-1513 |
| Practice Telephone | 3017744400 |
| Practice Fax Number | 3017741034 |
| Mailing Telephone | 3017744400 |
| Mailing Fax Number | 3017741034 |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2013-09-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
D44289 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 090907600 | 05 |
| Street Address |
18111 PRINCE PHILIP DR SUITE T-14 |
| City | OLNEY |
| State | MD |
| Zip Code | 20832-1513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447253679 | Susanne T Woodlan | Specialist | 18111 Prince Philip Dr, Ste 111, Olney, MD 20832-1503 | 2005-05-23 |
| 1952787400 | Lera Salvatierra Ison | Nurse Practitioner | 18111 Prince Philip Dr, Ste 300, Olney, MD 20832-1513 | 2015-08-07 |
| 1043691884 | Sherry Hood Dulling | Nurse Practitioner | 18111 Prince Philip Dr, Suite 300, Olney, MD 20832-1507 | 2015-06-17 |
| 1518359066 | The Neurology Clinic of Washington | Clinical Nurse Specialist | 18111 Prince Philip Dr, Suite 124, Olney, MD 20832-1513 | 2015-02-20 |
| 1497150411 | Michele Parent | Physical Therapist | 18111 Prince Philip Dr, Suite 125, Olney, MD 20832-1513 | 2014-11-03 |
| 1487089819 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 18111 Prince Philip Dr, Suite 221, Olney, MD 20832 | 2013-09-04 |
| 1346506219 | Mclmhp Inc. | Clinic/Center | 18111 Prince Philip Dr, Suite 312, Olney, MD 20832-1513 | 2012-04-05 |
| 1881963544 | Phs Orhthopaedics Olney | General Acute Care Hospital | 18111 Prince Philip Dr, Suite 208, Olney, MD 20832-1513 | 2011-12-23 |
| 1568745750 | Allyson Deborah Bull | Audiologist | 18111 Prince Philip Dr, Suite 224, Olney, MD 20832-1513 | 2011-09-23 |
| 1194023234 | Ashraf M. Sufi, M.d. LLC | Internal Medicine | 18111 Prince Philip Dr, Suite 202, Olney, MD 20832-1513 | 2011-03-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417443532 | Ludmila Costenco | Behavior Technician | 18218 Fox Chase Cir, Olney, MD 20832 | 2018-07-02 |
| 1912422874 | Shannon Denham Nguy | Nurse Practitioner | 18109 Prince Philip Dr Ste 300, Olney, MD 20832 | 2017-08-11 |
| 1578092904 | Rodney John Bohlmann | Naturopath | 17517 Queen Elizabeth Drive, Olney, MD 20832 | 2017-06-08 |
| 1972999746 | Arooj Babar | Internal Medicine | 18101 Prince Philip Dr Ste 230n, Olney, MD 20832 | 2015-04-08 |
| 1437547684 | Cynthia Ann Cook | Social Worker | 18006 Vintage River Terrace, Olney, MD 20832 | 2014-12-22 |
| 1598165334 | Gedion Haile | Pharmacist | 3110 Onley Sandy Spring Rd, Onley, MD 20832 | 2014-08-29 |
| 1285047902 | Melanie Ann Grady | Family Medicine | 18109 Prince Phillip Drive, Suite B200, Olney, MD 20832 | 2014-06-10 |
| 1063847267 | Mari Nako Tchantcho | Home Health Aide | 17149 Moss Side Lane, Olney, MD 20832 | 2013-09-06 |
| 1033558358 | Emily Sue Browning | Dentist | 3416 Olandwood Court, Suite 205, Suite 205, Olney, MD 20832 | 2013-06-19 |
| 1487093167 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 3414 Olandwood Court, Olney, MD 20832 | 2013-06-17 |
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| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194023234 | Ashraf M. Sufi, M.d. LLC | Internal Medicine | 18111 Prince Philip Dr, Suite 202, Olney, MD 20832-1513 | 2011-03-13 |
| 1083645220 | Montgomery Internal Medicine Assoc., P.a. | Internal Medicine | 2901 Olney Sandy Spring Rd, Olney, MD 20832-1521 | 2006-07-05 |
| 1215908819 | Ashraf M Sufi | Internal Medicine | 18111 Prince Philip Dr, 202, Olney, MD 20832-1513 | 2006-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477160984 | Lifebridge Community Physicians Inc | Internal Medicine | 8875 Centre Park Dr Ste D, Columbia, MD 21045-2382 | 2020-09-29 |
| 1790318657 | Margaret Geraldine Keane | Internal Medicine | Sheikh Zayed Tower, 1800 Orleans St, Baltimore, MD 21287 | 2020-02-19 |
| 1093354698 | Urooj Ahmed | Internal Medicine | 11110 Medical Campus Rd Ste 250, Hagerstown, MD 21742-6756 | 2019-12-30 |
| 1588155733 | Maryland Inpatient Specialist LLC | Internal Medicine | 10110 Molecular Dr Ste 109, Rockville, MD 20850-7538 | 2018-05-23 |
| 1750709333 | Alireza Meighani | Internal Medicine | 7501 Surratts Rd Ste 206, Clinton, MD 20735-3373 | 2014-04-01 |
| 1689912677 | Donald Edward Wilson | Internal Medicine | 20 Penn St, Baltimore, MD 21201-1075 | 2013-01-25 |
| 1124374418 | Ruhail Kohli | Internal Medicine | 4940 Eastern Ave Fl 5, Baltimore, MD 21224 | 2012-07-24 |
| 1922364959 | Huimin Yu | Internal Medicine | 600 N Wolfe St Bldg 9, Baltimore, MD 21287-0005 | 2012-04-04 |
| 1700175635 | David Stuart Jencks | Internal Medicine | 820 Bestgate Rd Ste 2a, Annapolis, MD 21401 | 2011-03-31 |
| 1134438575 | Boo Keun Kim, Md, Pa | Internal Medicine | 8921 Shady Grove Court, Gaithersburg, MD 20877-1308 | 2010-10-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.