| NPI | 1770659609 |
|---|---|
| Doing Business As | WILDEWOOD MEDICAL CARE |
| Entity Type | Organization |
| Authorized Contact | JOHN SCOTT TIDBALL Owner 301-737-7833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D52196) |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2011-04-04 |