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General NPI Number Information
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NPI Number | 1801731278
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Entity Type | Organization
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Legal Business Name | WCG MD PC
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 6811 CAMPFIELD RD
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City | BALTIMORE
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State | MD
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Zip | 21207-4657
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Country | US
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Telephone | 973-427-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 290 LAFAYETTE AVE
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City | HAWTHORNE
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State | NJ
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Zip | 07506-1961
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Country | US
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Telephone | 973-427-9200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SEKULEO GATHERS
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Credential | MD
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Telephone | 973-427-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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