Individual
DR. RICHARD GREGORY WIRTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
818 HIGH ST, SUITE 5, CHESTERTOWN, MD 21620-1152
(410) 778-5550
(410) 778-0984
Mailing address
952 WASHINGTON AVE, SUITE 5, CHESTERTOWN, MD 21620-3322
(410) 778-5550
(410) 778-0984
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
02027
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001127
VALUE OPTIONS ID#
MD
01
—
30956
MAMSI/UBH ID#
MD
01
—
31166
JOHNS HOPKINS ID#
MD
01
—
61-45371
UBH ID#
MD
01
—
68134
AMERICAN PSYCH SYSTEM #
MD
01
—
LT86-399909-03
BCBS LOCAL GROUP #
MD
01
—
T4180001
BLUE CROSS NAT GROUP #
MD
Enumeration date
08/22/2006
Last updated
04/08/2016
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