Wanda J Wicks MD

NPI 1053477992 - Family Medicine - 207Q00000X

NPI Details
NPI 1053477992
Gender Female
Enumeration Date 12/28/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
4920 CAMPBELL BOULAVARD
BALTIMORE MD, 21236-5916, US
Phone (410) 933-7600
Fax (410) 933-7601
Business Location
2101 EAST JEFFERSON STREET
PPQA MEDICARE COMPLIANCE UNIT 6 WEST
ROCKVILLE MD, 20852-4908, US
Phone (301) 816-6660
Fax (301) 816-6308
Toxanomy
Taxonomy Code 207Q00000X
License State Maryland
License Number D36343
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According to our database, Dr. Wanda J Wicks MD NPI is 1053477992, taxonomy code is 207Q00000X and license number is D36343, license state is located at Maryland. Wanda J Wicks MD physically located at 4920 Campbell Boulavard, Baltimore MD, 21236-5916. NPI Number Wanda J Wicks MD has the Individual type.

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1053477992 NPI number is provided on an as is basis without warranty of any kind. 1053477992 is maintained by the National Plan & Provider Enumeration System. The contents of Wanda J Wicks MD are for informational purposes only.