Individual
DR. WYATT CLARENCE TO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
63 THOMAS JOHNSON DR, SUITE, FREDERICK, MD 21702-4384
(301) 698-2424
(301) 698-1018
Mailing address
63 THOMAS JOHNSON DR, STE B, FREDERICK, MD 21702-4396
(240) 446-4035
Taxonomy
Speciality
Code
Description
License number
State
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Primary
M55987
MD
Other
Enumeration date
11/21/2005
Last updated
06/08/2018
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