Individual
RENEE DENISE WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5064 KILBURN ST, ALEXANDRIA, VA 22304-7766
(703) 888-0486
Mailing address
5064 KILBURN ST, ALEXANDRIA, VA 22304-7766
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD-13986
HI
Other
Enumeration date
05/20/2008
Last updated
05/20/2008
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