Individual
DR. DAVID MICHAEL WANALISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10231 OLD OCEAN CITY BLVD, SUITE 210, BERLIN, MD 21811
(410) 641-9482
(410) 641-9516
Mailing address
9733 HEALTHWAY DRIVE, BERLIN, MD 21811
(856) 691-8444
(856) 691-8325
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
25MB07794500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193571200
—
MD
Enumeration date
07/10/2006
Last updated
11/05/2024
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