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Individual

DR. SUSAN ELIZABETH WANDISHIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
10085 RED RUN BLVD, SUTIE 103, OWINGS MILLS, MD 21117-4836
(410) 363-2240
(410) 363-3858
Mailing address
10085 RED RUN BLVD, SUTIE 103, OWINGS MILLS, MD 21117-4836
(410) 363-2240
(410) 363-3858

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0040033
MD

Other

Enumeration date
08/22/2006
Last updated
07/08/2007
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