Individual
MR. JASON BRENT WANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
800 PRINCE FREDERICK BLVD., PRINCE FREDERICK, MD 20678
(410) 535-2270
(410) 535-5749
Mailing address
800 PRINCE FREDERICK BLVD., PRINCE FREDERICK, MD 20678
(410) 535-2270
(410) 535-5749
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
H0062629
MD
Other
Enumeration date
07/31/2006
Last updated
11/27/2007
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