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General NPI Number Information
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NPI Number | 1851875173
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Entity Type | Individual
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Provider Name | ANDREW TYLER WILSON DPM
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Gender | Male
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Dates
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Enumeration Date | 09/21/2018
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 7602 BELAIR RD
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City | BALTIMORE
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State | MD
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Zip | 21236-4088
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Country | US
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Telephone | 410-661-3338
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Fax |
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Provider Business Mailing Address
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Address Line | 650 CEDAR CREEK GRADE STE 108
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City | WINCHESTER
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State | VA
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Zip | 22601-6453
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Country | US
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Telephone | 540-667-3338
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 0103301475
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 9857
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License Number State | MD
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