Provider Demographics
NPI:1174616692
Name:BILOWUS, MARK LAWRENCE (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:LAWRENCE
Last Name:BILOWUS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1850 TOWN CENTER PARKWAY
Mailing Address - Street 2:SUITE 409
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190
Mailing Address - Country:US
Mailing Address - Phone:703-478-0260
Mailing Address - Fax:703-478-2718
Practice Address - Street 1:1850 TOWN CENTER PARKWAY
Practice Address - Street 2:SUITE 409
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190
Practice Address - Country:US
Practice Address - Phone:703-478-0260
Practice Address - Fax:703-478-2718
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101038025208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC62085Medicare UPIN
VABI156819Medicare ID - Type Unspecified