Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | D0024542 | MD |
NPI | 1184658148 |
---|---|
Provider Name | Charles Michael Wax |
First Address | Jarrettsville, MD 21084-1329 |
Second Address | Forest Hill, MD 21050-2624 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 04/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010183 | EMPLOYEE HEALTH PLAN (01) | MD |
010183 | JOHNS HOPKINS HEALTH PLAN (01) | MD |
1930001 | BXBS BLUE CHOICE HMO (01) | DC |
1930001 | BXBS FEDERAL (01) | MD |
290708 | ALLIANCE PPO (01) | MD |
290708 | MAMSI LIFE AND HEALTH (01) | MD |
290708 | MD-IPA (01) | MD |
290708 | OPTIMUM CHOICE HMO (01) | MD |
290708 | UNITED HEALTHCARE (01) | MD |
34076 | COVENTRY HEALTHCARE (01) | DE |
3711148 | CIGNA HEALTHCARE (01) | CT |
4217234 | AETNA HEALTHCARE (01) | PA |
494353 | NATIONAL CAPITOL PPO (01) | DC |
67160 | PRIVATE HEALTHCARE SYSTEM (01) | |
8905CM | MARYLAND BXBS (01) | MD |