Individual
MARTIN ANTHONY KORKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
44055 RIVERSIDE PARKWAY, SUITE 216, LEESBURG, VA 20176-5179
(703) 858-1395
(703) 858-7468
Mailing address
224 D CORNWALL STREET NW, STE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101048127
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010132029
—
VA
05
—
1801880752
—
VA
05
—
30016354550001
—
VA
01
—
P00200904
RR MEDICARE
VA
Enumeration date
09/07/2005
Last updated
03/18/2024
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