Provider Demographics
NPI:1962743708
Name:WILSON-MOULING, LEKHA K (PHARMD)
Entity type:Individual
Prefix:
First Name:LEKHA
Middle Name:K
Last Name:WILSON-MOULING
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3297 CRAIN HWY
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4848
Mailing Address - Country:US
Mailing Address - Phone:301-542-4200
Mailing Address - Fax:
Practice Address - Street 1:3297 CRAIN HWY
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4848
Practice Address - Country:US
Practice Address - Phone:301-542-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-04
Last Update Date:2021-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist