Provider Demographics
NPI:1518207042
Name:CORE HEALTH AND WELLNESS CENTER
Entity Type:Organization
Organization Name:CORE HEALTH AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-302-3996
Mailing Address - Street 1:2516 SHERIDAN RD SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-5265
Mailing Address - Country:US
Mailing Address - Phone:202-610-6106
Mailing Address - Fax:202-610-6106
Practice Address - Street 1:2516 SHERIDAN RD SE
Practice Address - Street 2:SUITE A
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5265
Practice Address - Country:US
Practice Address - Phone:202-610-6106
Practice Address - Fax:202-610-6106
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORE HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty