Individual
SCOTT WILFONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
421 FALLSWAY, BALTIMORE, MD 21202-4800
(443) 703-1253
Mailing address
421 FALLSWAY, BALTIMORE, MD 21202-4800
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
16218
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
327418SW
VALUE OPTIONS
MD
Enumeration date
12/09/2010
Last updated
12/10/2010
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