Organization
CCRAB ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE A WENZEL (OFFICE MANAGER)
(301) 645-0366
Entity
Organization
Contact information
Practice address
3261 OLD WASHINGTON RD, SUITE 1010, WALDORF, MD 20602-3223
(301) 645-0366
(301) 843-4773
Mailing address
3261 OLD WASHINGTON RD, SUITE 1010, WALDORF, MD 20602-3223
(301) 645-0366
(301) 843-4773
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00399
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403912200
—
MD
Enumeration date
02/13/2008
Last updated
09/22/2008
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