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General NPI Number Information
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NPI Number | 1508966540
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Entity Type | Individual
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Provider Name | JOHN FRANCIS VANWIE P.D.
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Gender | Male
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9106 PHILADELPHIA RD SUITE 100
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City | BALTIMORE
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State | MD
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Zip | 21237-4329
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Country | US
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Telephone | 410-687-8113
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Fax | 410-391-3922
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Provider Business Mailing Address
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Address Line | 248 EARECKSON LN
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City | STEVENSVILLE
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State | MD
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Zip | 21666-3040
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Country | US
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Telephone | 410-643-0877
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Fax | 410-643-1175
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10319
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License Number State | MD
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