Keith D Wilson JR. MD

NPI 1720248198 - General Practice - 208D00000X

NPI Details
NPI 1720248198
Gender Male
Enumeration Date 06/10/2008
Last Updated 05/31/2011
Entity Type Individual
Active Over 8 years ago
Practice Location
11722 REISTERSTOWN RD
REISTERSTOWN MD, 21136-3302, US
Phone (410) 833-5000
Fax (410) 833-1433
Business Location
PO BOX 1708
GREENBELT MD, 20768-1708, US
Phone
Fax
Toxanomy
Taxonomy Code 208D00000X
License State Maryland
License Number D71538
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According to our database, Keith D Wilson JR. MD NPI is 1720248198, taxonomy code is 208D00000X and license number is D71538, license state is located at Maryland. Keith D Wilson JR. MD physically located at 11722 Reisterstown Rd, Reisterstown MD, 21136-3302. NPI Number Keith D Wilson JR. MD has the Individual type.

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1720248198 NPI number is provided on an as is basis without warranty of any kind. 1720248198 is maintained by the National Plan & Provider Enumeration System. The contents of Keith D Wilson JR. MD are for informational purposes only.