DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JACK LAURENCE WAPNER, M.D.

Active Sole Proprietor

DR. JACK LAURENCE WAPNER, M.D. is a Addiction Psychiatry healthcare provider located in RANDALLSTOWN, Maryland. NPI 1164688677 is currently active in the NPPES registry. Verify at CMS.

Addiction Psychiatry · RANDALLSTOWN, MD

Registration Details

NPI Number
1164688677
Provider Type
Individual
Gender
Male
NPI Issued
Aug 4, 2008 (18.050353412071 yrs)
Last Updated
Aug 4, 2008
License
D0026048 (MD)
Sole Proprietor
Yes

Practice Information

Address
11100 LIBERTY RD
SUITE F
RANDALLSTOWN, MD, 211331026
Browse MD providers · Browse ZIP 21133
Phone
4106552740
Fax
4106554740
Primary Specialty
Addiction Psychiatry
2084A0401X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.