Individual
DR. DAVID MICHAEL WIDLUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22 S GREENE ST, ROOM N2E16, BALTIMORE, MD 21201-1544
(410) 328-5656
(410) 328-2115
Mailing address
2207 SHADED BROOK DR, OWINGS MILLS, MD 21117-2347
(410) 554-2590
(410) 554-2643
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D0035001
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
561371000
—
MD
Enumeration date
07/18/2006
Last updated
12/27/2011
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