Healthcare Provider Details

I. General information

NPI: 1154551596
Provider Name (Legal Business Name): WJWR PHYSICIANS ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 UNIVERSITY BLVD E STE 37
SILVER SPRING MD
20903-2915
US

IV. Provider business mailing address

831 UNIVERSITY BLVD E STE 37
SILVER SPRING MD
20903-2915
US

V. Phone/Fax

Practice location:
  • Phone: 301-328-7155
  • Fax: 301-328-7182
Mailing address:
  • Phone: 301-328-7155
  • Fax: 301-328-7182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WILKINSON J NINALA
Title or Position: PRESIDENT
Credential: MD
Phone: 301-328-7155