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Individual

SHEETAL HARISH WAGLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD, MBBS

Contact information

Practice address
10770 HICKORY RIDGE ROAD, COLUMBIA, MD 21044-3646
(410) 988-4013
Mailing address
10770 HICKORY RIDGE ROAD, COLUMBIA, MD 21044-3646
(410) 988-4013

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
D0072106
MD
2084N0600X
Clinical Neurophysiology Physician
D0072106
MD
390200000X
Student in an Organized Health Care Education/Training Program
0116018133
VA

Other

Enumeration date
05/21/2007
Last updated
11/30/2011
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