Provider Demographics
NPI:1588476451
Name:WARGOWSKY, RICHARD SAMUEL
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:SAMUEL
Last Name:WARGOWSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1552 MOORINGS DR APT 11B
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190
Mailing Address - Country:US
Mailing Address - Phone:703-282-0955
Mailing Address - Fax:
Practice Address - Street 1:1364 CLIFTON RD NE DEPT OF
Practice Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1059
Practice Address - Country:US
Practice Address - Phone:404-727-5910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program