MEDICARE: FITZPATRICK CHRISPIN WILSON 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	208100000X	Physical Medicine & Rehabilitation Physician	D0078812	MD
2	208100000X	Physical Medicine & Rehabilitation Physician	0101057645	VA

General Provider Information

NPI Number	:	1427028166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FITZPATRICK CHRISPIN WILSON MD

Provider Business Mailing Address
First Line	:	9601 PULASKI PARK DR
Second Line	:	SUITE 416
City	:	MIDDLE RIVER
State	:	MD
Zip	:	21220-1409
Country	:	US
Telephone Number	:	410-933-5678
Fax Number	:	410-933-3923

Provider Business Practice Location Address
First Line	:	9601 PULASKI PARK DR
Second Line	:	SUITE 416
City	:	MIDDLE RIVER
State	:	MD
Zip	:	21220-1409
Country	:	US
Telephone Number	:	410-933-5678
Fax Number	:	410-933-3923

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	01/27/2025

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