Provider Demographics
NPI:1316112535
Name:MUWOWO, MASOZI RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:MASOZI
Middle Name:RICHARD
Last Name:MUWOWO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MASOZI
Other - Middle Name:RICHARD
Other - Last Name:MUWOWO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6100 EVERY SAIL PATH
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-2904
Mailing Address - Country:US
Mailing Address - Phone:410-440-7502
Mailing Address - Fax:
Practice Address - Street 1:2101 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4908
Practice Address - Country:US
Practice Address - Phone:800-227-6647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233637207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology