Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 37400 | TN |
N | 207RN0300X | Nephrologist | M7761 | TX |
NPI | 1073639886 |
---|---|
Provider Name | Matthew Hunter Wilson |
First Address | Nashville, TN 37232-2372 |
Second Address | Nashville, TN 37232-2372 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 21/05/2021 |