Ted Lewis Wilson PHYSICIANS ASSISTANT

NPI 1063685592 - Physician Assistant - 363AM0700X

NPI Details
NPI 1063685592
Gender Male
Enumeration Date 04/04/2008
Last Updated 04/04/2008
Entity Type Individual
Active Over 9 years ago
Practice Location
7210 WINDSOR BLVD
RUTHERFORD BUSINESS CENTER
BALTIMORE MD, 21244-2633, US
Phone (410) 597-7438
Fax (410) 597-7722
Business Location
7210 WINDSOR BLVD
RUTHERFORD BUSINESS CENTER
BALTIMORE MD, 21244-2633, US
Phone (410) 597-7438
Fax (410) 597-7722
Toxanomy
Taxonomy Code 363AM0700X
License State Maryland
License Number C00001109
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According to our database, Mr. Ted Lewis Wilson PHYSICIANS ASSISTANT NPI is 1063685592, taxonomy code is 363AM0700X and license number is C00001109, license state is located at Maryland. Ted Lewis Wilson PHYSICIANS ASSISTANT physically located at 7210 Windsor Blvd, Baltimore MD, 21244-2633. NPI Number Ted Lewis Wilson PHYSICIANS ASSISTANT has the Individual type.

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1063685592 NPI number is provided on an as is basis without warranty of any kind. 1063685592 is maintained by the National Plan & Provider Enumeration System. The contents of Ted Lewis Wilson PHYSICIANS ASSISTANT are for informational purposes only.