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General NPI Number Information
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NPI Number | 1275703696
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Entity Type | Organization
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Legal Business Name | WAYNE K KNOLL, DPM
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Dates
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Enumeration Date | 03/03/2008
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Last Update Date | 07/01/2009
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Provider Practice Location Address
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Address Line | 32 COX RD
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City | HUNTINGTOWN
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State | MD
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Zip | 20639-9278
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Country | US
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Telephone | 410-266-8223
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Fax | 410-535-0802
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Provider Business Mailing Address
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Address Line | 32 COX RD
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City | HUNTINGTOWN
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State | MD
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Zip | 20639-9278
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Country | US
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Telephone | 410-266-8223
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Fax | 410-535-0802
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Authorized Official
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Title or Position | OWNER
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Name | DR. WAYNE K KNOLL JR.
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Credential | DPM
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Telephone | 410-266-8223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 01252
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License Number State | MD
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