Individual
DR. JARL THOMAS WATHNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
11110 MEDICAL CAMPUS RD, STE 126, HAGERSTOWN, MD 21742-6799
(301) 714-4375
(301) 714-4365
Mailing address
11110 MEDICAL CAMPUS RD, STE 126, HAGERSTOWN, MD 21742-6799
(301) 714-4375
(301) 714-4365
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
D0046383
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005 H883
CAREFIRST REGIONAL NTWRK
MD
05
—
148591100 793251101
—
MD
01
—
2172963
MAMSI
MD
01
—
50002834 GP 02426700
CAPITAL BLUE CROSS
MD
01
—
516615 GRP 59855
PA BS MD LOCATION
MD
01
—
516773 GRP 593934
PA BS PA LOCATION
PA
01
—
53302402 S186
CAREFIRST BS IND & GRP
MD
Enumeration date
06/01/2005
Last updated
03/12/2008
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