Provider Demographics
NPI:1154551596
Name:WJWR PHYSICIANS ASSOCIATES INC
Entity type:Organization
Organization Name:WJWR PHYSICIANS ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILKINSON
Authorized Official - Middle Name:J
Authorized Official - Last Name:NINALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-328-7155
Mailing Address - Street 1:831 UNIVERSITY BLVD E STE 37
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2915
Mailing Address - Country:US
Mailing Address - Phone:301-328-7155
Mailing Address - Fax:301-328-7182
Practice Address - Street 1:831 UNIVERSITY BLVD E STE 37
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2915
Practice Address - Country:US
Practice Address - Phone:301-328-7155
Practice Address - Fax:301-328-7182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD601181100Medicaid