Provider Demographics
NPI:1487782124
Name:HUNT, WAYNE PHILIP (EDD, ABPP)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:PHILIP
Last Name:HUNT
Suffix:
Gender:M
Credentials:EDD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 OLD BARN RD
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21120-9421
Mailing Address - Country:US
Mailing Address - Phone:410-523-8900
Mailing Address - Fax:
Practice Address - Street 1:1111 PARK AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5656
Practice Address - Country:US
Practice Address - Phone:410-523-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1806103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1806OtherLICENSED PSYCHOLOGIST NO.