Healthcare Provider Details

I. General information

NPI: 1063695005
Provider Name (Legal Business Name): WARNER & VANMETER M.D.PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2007
Last Update Date: 12/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 THOMAS JOHNSON DR SUITE A
FREDERICK MD
21702-4384
US

IV. Provider business mailing address

63 THOMAS JOHNSON DR SUITE A
FREDERICK MD
21702-4384
US

V. Phone/Fax

Practice location:
  • Phone: 301-663-0400
  • Fax: 301-663-1906
Mailing address:
  • Phone: 301-663-0400
  • Fax: 301-663-1906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LARRY WARNER
Title or Position: OWNER
Credential: M.D.
Phone: 301-663-0400