Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | D0031474 | MD |
N | 207XS0106X | Orthopaedic Hand Surgeon | D0031474 | MD |
Y | 2086S0105X | Surgery of the Hand | D0031474 | MD |
NPI | 1407810690 |
---|---|
Provider Name | Dr. Bruce S. Wolock |
First Address | Towson, MD 21204-2065 |
Second Address | Towson, MD 21204-2065 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 13/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
331950400 | (05) | MD |
903A | CAREFIRST MARYLAND (01) | MD |
DC8030 | RAILROAD MEDICARE (01) | MD |
DE5302 | RAILROAD MEDICARE (01) | MD |
E03190 | (02) | |
J848 | CAREFIRST DC (01) | MD |