Provider Demographics
NPI:1699111542
Name:WILKINSON, JARED D (MD)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:D
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:3300 GALLOWS RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3307
Practice Address - Country:US
Practice Address - Phone:703-776-3656
Practice Address - Fax:703-776-3515
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-20
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101264992207RP1001X, 208M00000X
MI4301102831208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease