Provider Demographics
NPI:1629161971
Name:WILKIE, HAROLD WASHINGTON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:WASHINGTON
Last Name:WILKIE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:77 WOODLAND WAY
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94611-3839
Mailing Address - Country:US
Mailing Address - Phone:510-653-2313
Mailing Address - Fax:510-595-7103
Practice Address - Street 1:6001 NORRIS CANYON RD
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-5400
Practice Address - Country:US
Practice Address - Phone:925-275-8280
Practice Address - Fax:925-275-8284
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG032679207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA45244Medicare UPIN