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Deactivated NPI 1992826861 Deactivated / Inactive NPI Male Practitioner

Dr. Edward Wilson , MD

Specialist • Largo, MD

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Edward Wilson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 02, 2007
NPI Deactivation Date September 09, 2019
Total Practice Duration ~12 Years of Practice (2007 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Edward Wilson, MD was a registered Specialist practicing in Largo, MD. Throughout an active medical career spanning 12 years, Dr. Wilson provided care at the practice location at 1221 MERCANTILE LN until profile deactivation on 2019-09-09.

Practice Location & Contact Primary Location

Practice Address

1221 Mercantile Ln

Largo, MD 207745374

Telephone 3016185500
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Largo, MD

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 36.9 Yrs
Regional Practice Density
3 Specialists

Practicing in Largo, MD (1034 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License MD D19322

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Lynn Thomas , MD

Internal Medicine

NPI 1003989377

Doctor of Medicine (M.D.)

Felicia Elvis , PA

Physician Assistant

NPI 1033100391

Physician Assistant

NPI 1033383781

Doctor of Medicine (M.D.)

Tina Musa

Obstetrics & Gynecology

NPI 1033572268
NPI 1043674708

Doctor of Medicine (M.D.)

NPI 1053731422

Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 09, 2019

Record deactivated on September 09, 2019

NPI Profile Active November 18, 2011

NPI status registered as active in NPPES database

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Updated Practice Location November 18, 2011

Registered at 1221 MERCANTILE LN, LARGO, MD 207745374 (Tel: 3016185500)

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Updated Business Mailing Address November 18, 2011

Registered at 2101 E JEFFERSON ST, KAISER PERMANTE MEDICARE ENROLLMENT, ROCKVILLE, MD 208524908 (Tel: 3018162424)

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Provider Name / Credentials Updated November 18, 2011

Recorded as EDWARD WILSON, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 18, 2011

Specialist (License #D19322 in MD)

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Initial NPI Registration & Enumeration April 02, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1992826861
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 02, 2007
Last Update: November 18, 2011
Deactivation Date: September 09, 2019

Mailing Address

2101 E Jefferson St, Kaiser Permante Medicare Enrollment

Rockville, MD 208524908

Phone: 3018162424

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.