DR. DAVID MICHAEL WILDER (NPI# 1073568887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073568887 |
| Entity Type | Individual |
| Full Name | DR. DAVID MICHAEL WILDER |
| Credential | DO, MPH |
| Practice Address |
11150 Fairfax Blvd Suite 550 Fairfax VA 22030-5066 |
| Mailing Address |
5912 Oakland Park Dr Burke VA 22015-2441 |
| Practice Telephone | 7039340621 |
| Mailing Telephone | 7037648057 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2008-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
0102201544 | VA | Allopathic & Osteopathic Physicians |
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
0102201544 | VA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366478323 | David Wilder | Social Worker | 919 3rd St Ste 101, Langley, WA 98260-9229 | 2006-06-23 |
| 1821441478 | David Wilder | Dentist | 3237 Sixes Rd, Canton, GA 30114-7965 | 2016-07-19 |
| 1760711154 | David Wilder | Behavioral Analyst | 150 W University Blvd, Melbourne, FL 32901-6982 | 2009-12-14 |
| 1225004682 | David William Wilder | Specialist | 200 Lothrop St, Room 3950 Chp Cmt, Pittsburgh, PA 15213-2546 | 2006-02-27 |
| Street Address |
11150 FAIRFAX BLVD SUITE 550 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-5066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013565019 | Hannah Sichel | Speech-Language Pathologist | 11150 Fairfax Blvd, Fairfax, VA 22030-5066 | 2019-09-03 |
| 1588158356 | Nathalie Marie Picayo | Speech-Language Pathologist | 11150 Fairfax Blvd, Fairfax, VA 22030-5066 | 2018-06-15 |
| 1588113922 | Jordan Bills | Speech-Language Pathologist | 11150 Fairfax Blvd, Suite 500, Fairfax, VA 22030-5066 | 2016-09-27 |
| 1225493802 | Nicole Elizabeth Herndon | Speech-Language Pathologist | 11150 Fairfax Blvd, Suite 500, Fairfax, VA 22030-5066 | 2015-12-23 |
| 1740645498 | Emily Kurinsky | Speech-Language Pathologist | 11150 Fairfax Blvd, Suite 500, Fairfax, VA 22030-5066 | 2015-12-23 |
| 1285041376 | Elizabeth Steiss Ventura | Speech-Language Pathologist | 11150 Fairfax Blvd, Suit 500, Fairfax, VA 22030-5066 | 2014-07-21 |
| 1114262102 | Victoria Matkowski | Speech-Language Pathologist | 11150 Fairfax Blvd, Suite 500, Fairfax, VA 22030-5066 | 2012-12-03 |
| 1568735785 | Vikas Puri | Dentist | 11150 Fairfax Blvd, Fairfax, VA 22030-5066 | 2012-02-18 |
| 1568743219 | Washington Speech-language Pathology Group Pllc | Speech-Language Pathologist | 11150 Fairfax Blvd, Suite 500, Fairfax, VA 22030-5066 | 2011-09-07 |
| 1225341647 | Thiago De Oliveira Matias | Dentist | 11150 Fairfax Blvd, Suite 301, Fairfax, VA 22030-5066 | 2010-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 2083P0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Public Health & General Preventive Medicine |
| Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154631356 | Peter Thomas Troell Jr. | Preventive Medicine | 10777 Main St, Suite 211, Fairfax, VA 22030-6903 | 2010-10-21 |
| 1134216674 | Gloria Ayeyidwom Addo Ayensu | Preventive Medicine | 10777 Main St, #203, Fairfax, VA 22030 | 2006-10-06 |
| 1215028030 | Achana V Ball | Preventive Medicine | 3750 Old Lee Hwy, Fairfax, VA 22030-1870 | 2006-09-27 |
| 1245321934 | Rajaa Satouri | Preventive Medicine | 10777 Main St, Fairfax, VA 22030-6903 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538792403 | Elaine Stanek Perry | Preventive Medicine | 45201 Research Pl Ste 120, Ashburn, VA 20147-2416 | 2020-02-19 |
| 1629546379 | Chang-i Wu | Preventive Medicine | 1530 Clarendon Blvd Apt 700, Arlington, VA 22209-4315 | 2018-11-09 |
| 1922541523 | Gregory Burkhart | Preventive Medicine | 12224 Quorn Ln, Reston, VA 20191-2635 | 2016-11-30 |
| 1114380359 | Sean C Mabey | Preventive Medicine | 2608 Nestlebrook Trl, Virginia Beach, VA 23456-8201 | 2016-04-04 |
| 1407269723 | Kim Xuan Luk | Preventive Medicine | 4480 King St Fl 3, Alexandria, VA 22302-1300 | 2014-06-04 |
| 1225458581 | Barbara Louise Johnson | Preventive Medicine | 412 W Stuart Dr, Galax, VA 24333-2737 | 2014-04-24 |
| 1811313943 | Passport Health Holdings, LLC. | Preventive Medicine | 2812 Emerywood Parkway, #160, Richmond, VA 23294 | 2014-03-13 |
| 1518397405 | Passport Health Holdings LLC | Preventive Medicine | 400 N Center Drive, Suite 108, Norfolk, VA 23502-0002 | 2013-11-14 |
| 1679827687 | James J James | Preventive Medicine | 16422 Wanderers Port Lane, Onancock, VA 23417 | 2012-10-30 |
| 1851667091 | Robert Peter Kadlec | Preventive Medicine | 2209 Traies Ct, Alexandria, VA 22306-2564 | 2012-03-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.