Individual
EMERSON M. WICKWIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
827 LINDEN AVE, BALTIMORE, MD 21201-4606
(410) 328-8141
(410) 328-0177
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 225-8000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
04597
MD
207RS0012X
Sleep Medicine (Internal Medicine) Physician
04597
MD
Other
Enumeration date
03/10/2009
Last updated
10/30/2019
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