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Individual

DR. RICHARD ALPHONSO WILSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
106 IRVING ST NW, SUITE 315, WASHINGTON, DC 20010-2927
(202) 723-8000
(202) 882-7333
Mailing address
106 IRVING ST NW, SUITE 315, WASHINGTON, DC 20010-2927
(202) 723-8000
(202) 882-7333

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
D0043663
MD
207RR0500X
Rheumatology Physician
Primary
MD11903
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004053756
AETNA
01
000783612
AMERICAN POSTAL WORKERS
05
010017400
DC
01
0735441
AETNA
01
0762
BLUE CROSS BLUE SHIELD
01
105547
AMERIGROUP
01
521444579
UNITED HEALTHCARE
01
521444579 0001
CIGNA
01
521444579 20010 A001
TRICARE
01
580P0762410001
CAREFIRST NATIONAL ACCOUN
Enumeration date
01/23/2007
Last updated
06/24/2008
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