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Individual
MARK R WILSON
Active
Individual
MARK R WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
MW046336
MI
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
4301046336
MI
Other
Enumeration date
06/14/2006
Last updated
12/05/2016
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