Erica Larae Wynn M.D.

NPI 1063585321 - Pediatrics - 208000000X

NPI Details
NPI 1063585321
Gender Female
Enumeration Date 11/16/2006
Last Updated 01/08/2008
Entity Type Individual
Active Over 10 years ago
Practice Location
14139 POTOMAC MILLS RD
WOODBRIDGE VA, 22192-4644, US
Phone (703) 490-7740
Fax
Business Location
14139 POTOMAC MILLS RD
WOODBRIDGE VA, 22192-4644, US
Phone (703) 490-7740
Fax
Toxanomy
Taxonomy Code 208000000X
License State DO Columbia
License Number MD035456
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According to our database, Erica Larae Wynn M.D. NPI is 1063585321, taxonomy code is 208000000X and license number is MD035456, license state is located at DO Columbia. Erica Larae Wynn M.D. physically located at 14139 Potomac Mills Rd, Woodbridge VA, 22192-4644. NPI Number Erica Larae Wynn M.D. has the Individual type.

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1063585321 NPI number is provided on an as is basis without warranty of any kind. 1063585321 is maintained by the National Plan & Provider Enumeration System. The contents of Erica Larae Wynn M.D. are for informational purposes only.