Provider Demographics
NPI:1497724389
Name:DOANE-WILSON, CATHLEEN O (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHLEEN
Middle Name:O
Last Name:DOANE-WILSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1860 TOWN CENTER DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5896
Mailing Address - Country:US
Mailing Address - Phone:703-796-0200
Mailing Address - Fax:703-796-1685
Practice Address - Street 1:20925 PROFESSIONAL PLZ
Practice Address - Street 2:SUITE 200
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3403
Practice Address - Country:US
Practice Address - Phone:703-726-9000
Practice Address - Fax:703-726-9105
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2008-12-10
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Provider Licenses
StateLicense IDTaxonomies
VA0101233283207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC63183Medicare UPIN