Wyatt, Carolyn

Wyatt, Carolyn is an sole proprietor health care provider with primary practice located at 8808 Centre Park Dr Suite 206, Columbia MD 21045-2126. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wyatt, Carolyn can be contacted via phone (410) 884-6116.

Contact Information

Primary practice address
8808 Centre Park Dr Suite 206 Columbia MD 21045-2126
Fax: (410) 730-1803
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X D0032932 Maryland

Profile Details

NPI number 1316999840
LBN Legal business name Wyatt, Carolyn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 16th, 2006
Last updated May 25th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316999840 NPPES
Maryland MEDICAID 597771103

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