DR. EDWARD WILSON (NPI# 1992826861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992826861 |
| Entity Type | Individual |
| Full Name | DR. EDWARD WILSON |
| Credential | M.D. |
| Practice Address |
1221 Mercantile Ln Largo MD 20774-5374 |
| Mailing Address |
2101 E Jefferson St Kaiser Permante Medicare Enrollment Rockville MD 20852-4908 |
| Practice Telephone | 3016185500 |
| Mailing Telephone | 3018162424 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2011-11-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | D19322 | MD | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588915425 | Edward S Wilson | Physician Assistant | 604 Bishop Dr, Virginia Beach, VA 23455 | 2012-10-01 |
| 1295944189 | Edward W. Wilson | Dentist | 30 E 60th St Rm 302, New York, NY 10022-7102 | 2007-05-21 |
| 1952462756 | Edward Wilson | Dentist | 23680 Us Highway 19 N, Clearwater, FL 33765-1571 | 2006-12-13 |
| 1417030685 | Edward D Wilson | Chiropractor | 4500 Hillcrest, #160, Frisco, TX 75035 | 2006-10-23 |
| 1326133752 | Edward Arthur Wilson | Social Worker | Delaware County Mental Health Clinic, One Hospital Road, Walton, NY 13856 | 2006-10-03 |
| 1194837500 | Edward S Wilson IIi | Psychologist | 1518 Savannah Rd, Lewes, DE 19958 | 2006-08-31 |
| 1376921809 | Edward Todd Wilson Jr. | Student in an Organized Health Care Education/Training Program | 462 Grider St, Erie County Medical Center: David K. Miller Building, Buffalo, NY 14215-3021 | 2015-05-17 |
| 1740668995 | Edward Wilson | Voluntary or Charitable | 1955 Long Beach Blvd, Long Beach, CA 90806-5501 | 2015-05-08 |
| 1619286713 | Edward W Wilson | Counselor | 4020 Palos Verdes Dr N, Suite 201, Rolling Hills Estates, CA 90274-2525 | 2010-10-07 |
| 1558484568 | Edward John Wilson | Dentist | 26365 Carmel Rancho Blvd, A, Carmel, CA 93923-8744 | 2007-04-06 |
| Street Address |
1221 MERCANTILE LN |
| City | LARGO |
| State | MD |
| Zip Code | 20774-5374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164425419 | Stephen J Ilario | Orthopaedic Surgery | 1221 Mercantile Ln, Largo, MD 20774-5374 | 2005-05-31 |
| 1780215020 | Malika Tamara Haylock-jones | Nurse Practitioner | 1221 Mercantile Ln, Largo, MD 20774-5374 | 2020-01-27 |
| 1346888427 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 1221 Mercantile Ln, Largo, MD 20774-5374 | 2019-12-19 |
| 1164069449 | Ashasha Tselat Sumbatyan | Physical Therapy Assistant | 1221 Mercantile Ln, Largo, MD 20774-5374 | 2019-12-05 |
| 1598316184 | Deepa L Cruz | Registered Nurse | 1221 Mercantile Ln, Largo, MD 20774-5374 | 2019-09-25 |
| 1639720204 | Charmaine Andra Mckie | Registered Nurse | 1221 Mercantile Ln, Largo, MD 20774-5374 | 2019-09-25 |
| 1669028338 | Shanelle Moore | Family Medicine | 1221 Mercantile Ln, Largo, MD 20774-5374 | 2019-08-17 |
| 1356815112 | Nanah Hannah Sevalie | Nurse Practitioner | 1221 Mercantile Ln, Largo, MD 20774-5374 | 2019-01-15 |
| 1215436183 | Shadana Maddox | Pharmacist | 1221 Mercantile Ln, Largo, MD 20774-5374 | 2018-02-06 |
| 1336650878 | Kyla Trenay Scott | Registered Nurse | 1221 Mercantile Ln, Largo, MD 20774-5374 | 2017-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922637156 | Marie Charlotte Teboutsou Tsodzou | Nurse Practitioner | 9317 Lavall Drive, Upper Marlboro, MD 20774 | 2020-04-08 |
| 1467093443 | Richland Support Services Corp. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11551 Joyceton Drive, Upper Marlboro, MD 20774 | 2019-10-01 |
| 1770134124 | Alan L Kahn | Counselor | 301 Largo Rd., Largo, MD 20774 | 2019-09-26 |
| 1619522034 | Francisca Ifeoma Alintah | Registered Nurse | 511 Dennis Magruder Dr., Upper Marlboro, MD 20774 | 2019-08-02 |
| 1609337146 | Crystal Osuchukwu | Counselor | 1300 Mccormick Dr, Upper Marlboro, MD 20774 | 2019-03-27 |
| 1861968489 | Collaborative Concepts of Maryland | Counselor | 1400 Mercantile Lane, Suite 208, Largo, MD 20774 | 2018-10-22 |
| 1073097622 | Triple Angels Homecare Services, Inc. | In Home Supportive Care | 1210 Dixie Bowie Way, Upper Marlboro, MD 20774 | 2018-09-19 |
| 1922589654 | Optimum Resource Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 711 Harry S. Truman Dr, Unit #105, Largo, MD 20774 | 2018-08-21 |
| 1811475254 | Kolawole Richard Olatunde | Home Health Aide | 11405 Villa Court, Upper Marlboro, MD 20774 | 2018-07-28 |
| 1548747769 | Tiara Williams | Counselor | 15207 Harriet Clotilda Way, Upper Marlboro, MD 20774 | 2018-07-20 |
| Find all providers in zip 20774 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598108706 | Kristin Woodward | Specialist | 1754 Indian Rocks Rd S, Largo, FL 33774-1027 | 2013-04-08 |
| 1093077711 | Betty Jakubik-randolph | Specialist | 740 13th Ave Sw, Largo, FL 33770-4442 | 2012-06-08 |
| 1891021713 | Frenchie Cooke Barron | Specialist | 8799 Bardmoor Blvd, #104, Largo, FL 33777-2236 | 2009-10-28 |
| 1043457666 | J. Paonessa M.d. P.a. | Specialist | 100 Highland Ave N, Largo, FL 33770-2542 | 2009-01-20 |
| 1689823031 | John Sellers | Specialist | 3497 19th Pl Sw, Largo, FL 33774-1139 | 2008-09-10 |
| 1043498934 | Kendall Bruce Eckert | Specialist | 4209 Imperial Palm Ct, Largo, FL 33771-1616 | 2008-02-04 |
| 1740319268 | Guy P Lafond | Specialist | 220 Poinciana Ln, Largo, FL 33770-2615 | 2007-03-02 |
| 1699840884 | Stephen T Duvall | Specialist | 333 16th Ave Se, Largo, FL 33771 | 2006-11-22 |
| 1457437055 | Michael King Jason | Specialist | 8839 Bryan Dairy Rd, Suite 300, Largo, FL 33777-1203 | 2006-10-27 |
| 1184711939 | Carol Jean Schultz | Specialist | 13300 Walsingham Road, # 85, Largo, FL 33774 | 2006-10-05 |
| Find all providers in LARGO | ||||
Please comment or provide details below to improve the information on DR. EDWARD WILSON.
| 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.