Individual
BETH H WIECZOREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
707 N BROADWAY, BALTIMORE, MD 21205-1832
(443) 923-9200
(443) 923-9405
Mailing address
2931 E BIDDLE ST, PATIENT ACCOUNTING, BALTIMORE, MD 21213-3939
(443) 923-1886
(443) 923-1895
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
R070205
MD
363LP0200X
Pediatric Nurse Practitioner
Primary
R070205
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53641602
CAREFIRST BC BS
MD
05
—
812114100
—
MD
Enumeration date
12/19/2006
Last updated
11/29/2023
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