Individual
ALYSON WYCHOZOWYCZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
23160 MOAKLEY ST, LEONARDTOWN, MD 20650-2922
(301) 475-5511
Mailing address
23160 MOAKLEY ST, LEONARDTOWN, MD 20650-2922
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00571400
NJ
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144384
NCCPA
—
Enumeration date
08/31/2017
Last updated
01/18/2024
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