Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | MD025253E | PA |
NPI | 1043286123 |
---|---|
Provider Name | David Wilson |
First Address | Pittsburgh, PA 15203-2348 |
Second Address | Pittsburgh, PA 15232-1301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 24/05/2021 |