Individual
MELODI LYNETTE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3650 JOSEPH SIEWICK DR, SUITE 203, FAIRFAX, VA 22033-1710
(703) 391-1500
(703) 860-1549
Mailing address
2028 OPITZ BLVD, SUITE ONE, WOODBRIDGE, VA 22191-3306
(703) 690-2295
(703) 690-6445
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101235867
VA
Other
Enumeration date
01/09/2007
Last updated
01/09/2015
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