Provider Demographics
NPI:1124186333
Name:NOWAK, JUDITH ANN (MD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ANN
Last Name:NOWAK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:908 NEW HAMPSHIRE AVENUE NW
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2349
Mailing Address - Country:US
Mailing Address - Phone:202-887-5495
Mailing Address - Fax:202-466-5582
Practice Address - Street 1:908 NEW HAMPSHIRE AVENUE NW
Practice Address - Street 2:SUITE 302
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2349
Practice Address - Country:US
Practice Address - Phone:202-887-5495
Practice Address - Fax:202-466-5582
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCMD118672084P0800X
MDD00231442084P0800X
VA01010271212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
171509Medicare ID - Type Unspecified
C62209Medicare UPIN