MARTHA L WILSON MD PA (NPI# 1457483869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457483869 |
| Entity Type | Organization |
| Organization Name | MARTHA L WILSON MD PA |
| Other Organization Name | MARTHA L WILSON MD PA PC |
| Practice Address |
104 E Stuart Dr Galax VA 24333-2119 |
| Practice Telephone | 2762389902 |
| Practice Fax Number | 2762389907 |
| Mailing Telephone | 2762389902 |
| Mailing Fax Number | 2762389907 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2010-06-07 |
| Authorized Official Name | DR. MARTHA L WILSON (PRESIDENT) |
| Authorized Official Telephone | 2762389902 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
49D1001134 | VA | Allopathic & Osteopathic Physicians |
| N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
Allopathic & Osteopathic Physicians | ||
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | 49D1001134 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | CLIA NUMBER | 49D1001134 | 01 |
| Other Name | Type Code |
|---|---|
| MARTHA L WILSON MD PA PC | Other Name - Individual/Organization |
| Street Address |
104 E STUART DR |
| City | GALAX |
| State | VA |
| Zip Code | 24333-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336271733 | Martha L Wilson | Dermatology | 104 E Stuart Dr, Galax, VA 24333-2119 | 2007-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225508872 | Family Preservation Services Inc. | Community/Behavioral Health | 140 D Larkspur Lane, Galax, VA 24333 | 2018-11-27 |
| 1215464292 | Emil William Sandstrom | Social Worker | 6999 Carrrolton Pike, Galax, VA 24333 | 2017-05-22 |
| 1548676505 | Ashley Allen Houk | Nurse Practitioner | 199 Hospital Dr Ste 7, Galax, VA 24333 | 2014-07-10 |
| 1043558745 | Oldtown Medical Care, LLC | Family Medicine | 306 Meadow St, Galax, VA 24333 | 2013-01-30 |
| 1447524152 | Karli Cathleen Meagher | Social Worker | 210 Calhoun Street, Galax, VA 24333 | 2012-02-27 |
| 1609003615 | Family Preservation Services, Inc | Community/Behavioral Health | 105 Rosenwald Felts Drive, Galax, VA 24333 | 2009-06-17 |
| 1730399452 | Stephen Earl Gause | Counselor | 6999 Carrollton Pike, Galax, VA 24333 | 2007-05-23 |
| 1326269903 | Rebecca L. Stanley | Counselor | 112 Painter Street, Galax, VA 24333 | 2007-05-01 |
| 1811075187 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 1047 East Stuart Dr, Unit 18, Galax, VA 24333 | 2006-11-02 |
| 1497858872 | Ethan Young Jones | Dentist | 1001 E Stuart Drive, Galax, VA 24333 | 2006-09-07 |
| Find all providers in zip 24333 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336271733 | Martha L Wilson | Dermatology | 104 E Stuart Dr, Galax, VA 24333-2119 | 2007-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902428709 | Clinical Dermatology Center, LLC | Dermatology | 14500 Avion Pkwy Ste 100, Chantilly, VA 20151-1108 | 2020-05-14 |
| 1760029904 | Loudoun Medical Group . P.c | Dermatology | 24560 Southpoint Dr Ste 230, Aldie, VA 20105-3504 | 2019-12-06 |
| 1588210330 | Brandi M Horner | Dermatology | 7650 E Parham Road, Ste 110, Richmond, VA 23294-4367 | 2019-08-16 |
| 1194383372 | Clarity Acne and Aesthetics LLC | Dermatology | 3345 Bridge Rd Ste 900, Suffolk, VA 23435-1848 | 2019-06-03 |
| 1356821235 | Sdm Virginia LLC | Dermatology | 4198 Cox Rd Ste 109, Glen Allen, VA 23060-3328 | 2018-08-20 |
| 1851877336 | Keri Church | Dermatology | 19455 Deerfield Ave Ste 311, Lansdowne, VA 20176-8102 | 2018-07-17 |
| 1972095974 | Verum Cutis Dermatology | Dermatology | 44110 Ashburn Shopping Plz Unit 237, Ashburn, VA 20147 | 2018-06-05 |
| 1710479936 | Integrated Dermatology of Gloucester, LLC | Dermatology | 6790 Wood Ridge Dr, Gloucester, VA 23061-4377 | 2018-06-04 |
| 1477077071 | Dulles Dermatology Associates, Pllc | Dermatology | 24430 Stone Springs Blvd Ste 275, Dulles, VA 20166-2247 | 2017-07-26 |
| 1487186466 | Integrated Dermatology of Reston, LLC | Dermatology | 1886 Metro Center Dr Ste 650, Reston, VA 20190-5294 | 2017-03-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.