| William A Wilson Md Pc | |
|
9261 Old Keene Mill Rd Burke VA 22015 | |
| (703) 451-9095 | |
| (703) 455-2239 |
| Full Name | William A Wilson Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9261 Old Keene Mill Rd, Burke, Virginia |
| Authorized Official Name and Position | William Allen Wilson (PRESIDENT PHYSICIAN) |
| Authorized Official Contact | 7034519095 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| William A Wilson Md Pc 9261 Old Keene Mill Rd Burke VA 22015 Ph: (703) 451-9095 | William A Wilson Md Pc 9261 Old Keene Mill Rd Burke VA 22015 Ph: (703) 451-9095 |
| NPI Number | 1376727792 |
|---|---|
| Provider Enumeration Date | 12/20/2007 |
| Last Update Date | 12/20/2007 |
| Medicare PECOS PAC ID | 1850558909 |
|---|---|
| Medicare Enrollment ID | O20120201000821 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376727792 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 32011 (Indiana) | Secondary |
| 207R00000X | Internal Medicine | VA0101037977 (Virginia) | Primary |
| 207R00000X | Internal Medicine | 43184 (Florida) | Secondary |
| Provider Name | William A Wilson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902939267 PECOS PAC ID: 4981861036 Enrollment ID: I20120201000901 |
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