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Individual

CRAIG WILDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2510 MOORES PLAINS BLVD, UPPER MARLBORO, MD 20774-8027
(202) 865-1121
(202) 865-4492
Mailing address
2024 GEORGIA AVE NW, WASHINGTON, DC 20001-3027
(202) 865-3415
(202) 865-6876

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD34904
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010119561
VA
05
406528000
MD
Enumeration date
09/27/2006
Last updated
12/27/2007
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