Individual
ROBERT WACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 W 7TH ST, FREDERICK, MD 21701-4506
(240) 566-3300
(240) 566-4872
Mailing address
400 W 7TH ST, FREDERICK, MD 21701-4506
(240) 566-3300
(240) 566-4872
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0051658
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
245940000
—
MD
Enumeration date
03/14/2006
Last updated
11/17/2009
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