NPI 1134102569

Wyatt Clarence to, MD

Practitioner Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician Frederick, MD

Practice location

Address: 63 Thomas Johnson Dr Suite, Frederick, MD 21702-4384
Phone: (301) 698-2424
Fax: (301) 698-1018
Mailing address: 63 Thomas Johnson Dr STE B, Frederick, MD 21702-4396

Registered specialties

Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2082S0099X Licence M55987 (MD)

Other Plastic Surgery providers in Maryland →

Registry record

NPI: 1134102569
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Nov 2005
Record last updated: 13 Jul 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.