Organization
KAISER PERMANENTE MID-ATLANTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELEANOR ANNE WILSON DPM (PODIATRIST)
(703) 922-1034
Entity
Organization
Contact information
Practice address
6501 LOISDALE CT, SPRINGFIELD, VA 22150-1826
(703) 922-1034
Mailing address
6010 GOOD LION CT, ALEXANDRIA, VA 22315-4623
(703) 922-1034
(703) 922-1628
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
0103000949
VA
Other
Enumeration date
04/20/2007
Last updated
08/08/2008
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