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Individual
THOMAS WILSON
Active
Individual
THOMAS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-049077
OH
207RC0000X
Cardiovascular Disease Physician
35-049077
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000130210
ANTHEM
OH
01
—
000000221214
UNISON
OH
01
—
000000503655
ANTHEM
OH
05
—
0607927
—
OH
01
—
18959
QUALCHOICE
OH
01
—
2597481
UNITED HEALTHCARE
OH
01
—
264168
FEDERAL BLACK LUNG
OH
01
—
341313510TW
SUMMACARE
OH
01
—
364138
WELLCARE
OH
01
—
4344500
AETNA
OH
01
—
741761
BUCKEYE
OH
01
—
P00358874
RAILROAD MEDICARE
OH
Enumeration date
03/22/2006
Last updated
01/11/2021
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