Provider Demographics
NPI:1740330083
Name:MORRIS J. WILKENFELD, MD
Entity type:Organization
Organization Name:MORRIS J. WILKENFELD, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:JACK
Authorized Official - Last Name:WILKENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-573-9220
Mailing Address - Street 1:3022 WILLIAMS DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4600
Mailing Address - Country:US
Mailing Address - Phone:703-573-9220
Mailing Address - Fax:703-573-9228
Practice Address - Street 1:3022 WILLIAMS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4600
Practice Address - Country:US
Practice Address - Phone:703-573-9220
Practice Address - Fax:703-573-9228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101031061207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG01896Medicare ID - Type UnspecifiedMEDICARE GROUP ID