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NPI Code Detail

MEDICARE: DR. DEBORAH D WILDER M.D.

MEDICARE: DR. DEBORAH D WILDER M.D.
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
1207V00000XObstetrics & Gynecology PhysicianMD32212DC
2207V00000XObstetrics & Gynecology Physician0101237400VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2178381OTHERVAANTHEM

General Provider Information

NPI Number : 1295704476
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBORAH D WILDER M.D.
Provider Business Mailing Address
First Line : 911 BRICK MANOR CIR
Second Line :
City : SILVER SPRING
State : MD
Zip : 20905-3818
Country : US
Telephone Number : 301-774-2042
Fax Number : 301-774-2043
Provider Business Practice Location Address
First Line : 2333 ONTARIO RD NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20009-2627
Country : US
Telephone Number : 202-483-8196
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 12/02/2025

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