Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | D0020281 | MD |
Y | 208600000X | Surgeon | D0020281 | MD |
NPI | 1003885013 |
---|---|
Provider Name | Dr. Max Eugene Wingerd |
First Address | Frederick, MD 21702-4300 |
Second Address | Frederick, MD 21702-4300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B69922 | (02) |