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Individual
DR. WANDA PAK
Active
Individual
DR. WANDA PAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
D 005640
MD
207W00000X
Ophthalmology Physician
Primary
M 32178
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D005640
MARYLAND MEDICAL LICENSE
MD
01
—
M 32178
STATE MEDICAL LICENSE
DC
Enumeration date
06/30/2006
Last updated
07/08/2007
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