Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD04244L | PA |
NPI | 1003836784 |
---|---|
Provider Name | Dr. Michael A Wilson |
First Address | York, PA 17402-9001 |
Second Address | York, PA 17406-8083 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 22/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001409263 | (05) | PA |
01105903 | CAPITAL BC-WMG SBFM (01) | PA |
030026 | JOHNS HOPKINS (01) | PA |
1142442 | AH MERCY-WMG SBFM (01) | PA |
1567482 | GATEWAY WRC (01) | PA |
186107 | UNISON-WMG READYCARE (01) | PA |
20054653 | AH MERCY-WMG READYCARE (01) | PA |
2161250 | MAMSI-WMG READYCARE (01) | PA |
233297 | MAMSI-WMG SBFM (01) | PA |
38597 | GEISINGER (01) | PA |
50062680 | CAPITAL BC-WMG READYCARE (01) | PA |
5274049 | AETNA (01) | PA |
543248 | CAREFIRST MD BCBS (01) | MD |
740064 | HIGHMARK (01) | PA |
740064 | HIGHMARK BLUE SHIELD (01) | PA |
81027 | UNISON-WMG SBFM (01) | PA |
F18580 | (02) | PA |
P002807 | GATEWAY-WMG (01) | PA |