MEDICARE: GLORIA WILDER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	0101055487	VA
2	208000000X	Pediatrics Physician	MD21918	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083758056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA WILDER MD

Provider Business Mailing Address
First Line	:	2516 SHERIDAN RD SE STE A
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-5265
Country	:	US
Telephone Number	:	202-610-6106
Fax Number	:	202-610-6107

Provider Business Practice Location Address
First Line	:	2516 SHERIDAN RD SE STE A
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-5265
Country	:	US
Telephone Number	:	202-610-6106
Fax Number	:	202-610-6107

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	03/09/2026

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Directions to “ GLORIA WILDER MD” Practice Location

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