Organization
THE NEUROSCIENCE TEAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER E KOZACHUK M.D. (NEUROLOGIST)
(410) 828-8700
Entity
Organization
Contact information
Practice address
22 WEST RD, SUITE 100, TOWSON, MD 21204-2326
(410) 828-8700
(410) 828-5620
Mailing address
22 WEST RD, SUITE 100, TOWSON, MD 21204-2326
(410) 828-8700
(410) 828-5620
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
D0037279
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01921410
—
MD
Enumeration date
02/16/2015
Last updated
02/16/2015
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