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Individual

MARK F. WILT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P. A.

Contact information

Practice address
12502 WILLOWBROOK RD, SUITE 470, CUMBERLAND, MD 21502-6491
(240) 964-8724
(240) 964-8735
Mailing address
193 SUGAR RD, LILLY, PA 15938-6016
(814) 886-8491
(301) 723-1480

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0003316
MD

Other

Enumeration date
12/08/2006
Last updated
02/15/2011
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