Provider Demographics
NPI:1679881957
Name:NOWAK, MEREDITH MARIE (AUD)
Entity type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:MARIE
Last Name:NOWAK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 OLD COURT RD STE 202
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-2894
Mailing Address - Country:US
Mailing Address - Phone:410-520-1222
Mailing Address - Fax:410-520-9114
Practice Address - Street 1:4000 OLD COURT RD
Practice Address - Street 2:STE 202
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-2800
Practice Address - Country:US
Practice Address - Phone:410-580-1222
Practice Address - Fax:410-580-9114
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01179231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD13803218OtherCAQH