Individual
PRISCILLA LYDIA WARNOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8601 VETERANS HWY, SUITE 204, MILLERSVILLE, MD 21108-1547
(410) 729-0424
(410) 729-0492
Mailing address
PO BOX 64042, BALTIMORE, MD 21264-4042
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0001680
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6002
BRAVO/ELDER HEALTH
MD
01
—
69933
AMERIGROUP
MD
01
—
970006233 CC0691
RR MEDICARE
MD
Enumeration date
06/21/2006
Last updated
04/16/2008
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