MEDICARE: EARL V. WILKINSON, M.D., LLC

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	207Y00000X	Otolaryngology Physician	D0027106	MD

Other Identifiers

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

General Provider Information

NPI Number	:	1700070513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EARL V. WILKINSON, M.D., LLC

Provider Business Mailing Address
First Line	:	5500 KNOLL NORTH DR
Second Line	:	SUITE 310
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2209
Country	:	US
Telephone Number	:	410-964-5226
Fax Number	:

Provider Business Practice Location Address
First Line	:	5500 KNOLL NORTH DR
Second Line	:	SUITE 310
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2209
Country	:	US
Telephone Number	:	410-964-5226
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. EARL VANE WILKINSON III
Credential	:	M.D.
Telephone Number	:	410-964-5226

Provider Enumeration Date	:	09/05/2007
Last Update Date	:	09/23/2011

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