Individual
DR. ELEANOR ANNE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
6501 LOISDALE COURT, SPRINGFIELD, VA 22150-1885
(703) 922-1034
(703) 922-1628
Mailing address
2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNIT 6 W, KAISER PERMANENTE MID ATL PERM MED GRP PC ATTN T.BROOKS, ROCKVILLE, MD 20852-4908
(301) 816-6660
(301) 816-6308
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103000949
VA
213E00000X
Podiatrist
01174
MD
Other
Enumeration date
11/28/2006
Last updated
02/09/2022
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