Organization
CAL ARUNDEL FAMILY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY JOHN WISNIEWSKI M.D. (OWNER)
(410) 414-9879
Entity
Organization
Contact information
Practice address
32 COX RD, HUNTINGTOWN, MD 20639-9278
(410) 414-9879
(410) 535-7684
Mailing address
32 COX RD, HUNTINGTOWN, MD 20639-9278
(410) 414-9879
(410) 535-7684
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207Q00000X
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205845799
INDIVIDUAL NPI
MD
05
—
407730000
—
MD
Enumeration date
11/18/2009
Last updated
01/11/2010
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