Individual
MR. JAMES WALTER PACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
750 OAKWILDE CT, MILLERSVILLE, MD 21108-1447
(410) 987-9110
Mailing address
750 OAKWILDE CT., MILLERSVILLE, MD 21108
(410) 987-9110
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C0001314
MD
Other
Enumeration date
02/12/2007
Last updated
07/08/2007
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