Matthew Ryan Kowalik, MD
Individual provider Active NPI Pediatric Gastroenterology Physician · Washington, DC
NPI 1477895290 · NPPES record last updated Jan 23, 2020
Key facts
- NPI
- 1477895290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Gastroenterology Physician 2080P0206X
- License
- MD046989 (DC)
- Practice address
- 111 Michigan Ave NW
Washington, DC 20010-2916 - Phone
- (202) 476-5000
- NPI assigned
- Mar 19, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD046989 | DC | MD | Pediatric Gastroenterology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD046989 | DC | |
| Pediatric Gastroenterology Physician | 2080P0206X | MD046989 | DC | Yes |
Addresses
Primary practice location
111 Michigan Ave NW
Washington, DC 20010-2916
Mailing address
PO Box 744785
Atlanta, GA 30374-4785
Phone (202) 476-5000
Other providers in Washington, DC
- Mark Kovler
- Kovu Healing
- Lauren Elizabeth Kowal
- Mary Kowal
- Keith John Kowalczyk
- Nicole Kowalik
- Christopher Edward Kowalski
- Gabrielle Nicole Kowalski
- Jacqueline Marie Kowitz
- Sandeep Kowkuntla
All providers in Washington, DC · Pediatric Gastroenterology Physician in District of Columbia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.