Individual
MR. GARY WEIDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW-C
Contact information
Practice address
11116 MEDICAL CAMPUS RD, SUITE 2989, HAGERSTOWN, MD 21742-6710
(301) 766-7600
(301) 766-7702
Mailing address
11116 MEDICAL CAMPUS RD, SUITE 2989, HAGERSTOWN, MD 21742-6710
(301) 766-7600
(301) 766-7702
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11518
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101057323
—
PA
05
—
401662900
—
MD
Enumeration date
06/30/2005
Last updated
08/11/2016
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