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NPI Code Detail

MEDICARE: JESSICA WIRE M.D.

MEDICARE: JESSICA WIRE 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
1207P00000XEmergency Medicine PhysicianME180068FL
2207P00000XEmergency Medicine Physician1024621MA
3207P00000XEmergency Medicine Physician0101269456VA
4207P00000XEmergency Medicine Physician036172729IL
5390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1316478472
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA WIRE M.D.
Provider Business Mailing Address
First Line : 2300 OPITZ BLVD
Second Line :
City : WOODBRIDGE
State : VA
Zip : 22191-3311
Country : US
Telephone Number : 703-523-1470
Fax Number :
Provider Business Practice Location Address
First Line : 2300 OPITZ BLVD
Second Line :
City : WOODBRIDGE
State : VA
Zip : 22191-3311
Country : US
Telephone Number : 703-523-1470
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2017
Last Update Date : 04/07/2026

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Directions to “ JESSICA WIRE M.D.” Practice Location

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