Individual
SHEMILE JOYCE MATA WIGGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12115 QUICK FOX LN, BOWIE, MD 20720-4322
(202) 573-4763
Mailing address
12115 QUICK FOX LN, BOWIE, MD 20720-4322
(202) 573-4763
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R189883
MD
Other
Enumeration date
05/06/2016
Last updated
05/06/2016
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