Individual
DR. JACQUELINE JOAN RACHEL WISNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2208 EASTLAKE RD, TIMONIUM, MD 21093-2706
(410) 982-8103
(410) 252-4054
Mailing address
2208 EASTLAKE RD, TIMONIUM, MD 21093-2706
(410) 982-8103
(410) 252-4054
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D75209
MD
Other
Enumeration date
11/04/2013
Last updated
08/04/2016
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