Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 2019045769 | MO |
N | 204F00000X | Transplant Surgeon | MD460429 | PA |
N | 208200000X | Surgeon | 273146 | NY |
N | 208600000X | Surgeon | 273146 | NY |
NPI | 1558627612 |
---|---|
Provider Name | Dr. Matthew Bruce Wilkinson |
First Address | Kansas City, MO 64111-5955 |
Second Address | Kansas City, MO 64111-5955 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2012 |
Last Update Date | 03/02/2020 |