Individual
MICHELLE WILSON JEFFERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3300 GALLOWS RD, DEPARTMENT OF MEDICINE, FALLS CHURCH, VA 22042-3307
(703) 776-3582
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2008-01093
NC
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
0101259072
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5909883
—
NC
05
—
N0109E
—
SC
Enumeration date
03/05/2007
Last updated
02/03/2021
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