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Individual

DR. MARY MONTRELLA WAYBILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
205 S FRONT ST, 8TH FLOOR BMA, HARRISBURG, PA 17104-1619
(717) 231-8700
(717) 231-8753
Mailing address
409 S 2ND ST, SUITE 2F, HARRISBURG, PA 17104-1612
(717) 231-8700
(717) 231-8753

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD043763E
PA
207RN0300X
Nephrology Physician
Primary
MD043763E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001168310
PA
Enumeration date
06/12/2007
Last updated
01/23/2021
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