Provider Demographics
NPI:1477521334
Name:WROBLEWSKI, JOHN J (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:WROBLEWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 DUAL HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6636
Mailing Address - Country:US
Mailing Address - Phone:301-665-1712
Mailing Address - Fax:301-665-1714
Practice Address - Street 1:1800 DUAL HWY STE 201
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6636
Practice Address - Country:US
Practice Address - Phone:301-665-1712
Practice Address - Fax:301-665-1714
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD059877L207W00000X, 207WX0107X
NMMD2014-0756207W00000X, 207WX0107X, 207W00000X
MDD0050019207WX0107X, 207W00000X
WV26186207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015648410003Medicaid
MD994400100Medicaid
MD101M989EMedicare PIN
PA0015648410003Medicaid
PA056993QGJMedicare PIN
MD994400100Medicaid