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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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