Individual
DR. JACK LAURENCE WAPNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11100 LIBERTY RD, SUITE F, RANDALLSTOWN, MD 21133-1026
(410) 655-2740
(410) 655-4740
Mailing address
11100 LIBERTY RD, SUITE F, RANDALLSTOWN, MD 21133-1026
(410) 655-2740
(410) 655-4740
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
D0026048
MD
Other
Enumeration date
08/04/2008
Last updated
08/04/2008
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