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NPI Code Detail

MEDICARE: LEEZA M WAGER PHARMD

MEDICARE: LEEZA M WAGER PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist17137MD

General Provider Information

NPI Number : 1790096527
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEEZA M WAGER PHARMD
Provider Business Mailing Address
First Line : 6402 GOLDEN RING RD
Second Line :
City : ROSEDALE
State : MD
Zip : 21237-2010
Country : US
Telephone Number : 410-866-2500
Fax Number : 410-866-6486
Provider Business Practice Location Address
First Line : 6402 GOLDEN RING RD
Second Line :
City : ROSEDALE
State : MD
Zip : 21237-2010
Country : US
Telephone Number : 410-866-2500
Fax Number : 410-866-6486
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2010
Last Update Date : 06/25/2010

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Directions to “ LEEZA M WAGER PHARMD” Practice Location

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