Organization
OLD LINE MEDICAL SERVICES, P.C.
Active
Organization
OLD LINE MEDICAL SERVICES, P.C.
Active
Other names
Convenient Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN EDWARD WIGGINS M.D. (PRESIDENT)
(301) 843-3888
Entity
Organization
Contact information
Practice address
12090 OLD LINE CTR, WALDORF, MD 20602-2556
(301) 843-3888
(301) 870-6838
Mailing address
12090 OLD LINE CTR, WALDORF, MD 20602-2556
(301) 843-3888
(301) 870-6838
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
MD
Other
Enumeration date
12/05/2006
Last updated
07/15/2010
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