Individual
MARK L WOLRAICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 NE 13TH ST, CSC, OKLAHOMA CITY, OK 73117-1039
(405) 271-6824
Mailing address
1122 NE 13TH ST, ORI236, OKLAHOMA CITY, OK 73117-1039
(405) 271-1515
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
22350
OK
Other
Enumeration date
03/12/2006
Last updated
07/08/2007
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