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Individual
DR. AMANDA LOUISE WILSON
Active
Individual
DR. AMANDA LOUISE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
049592
CT
207R00000X
Internal Medicine Physician
205246
MA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
4301505786
MI
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
60935430
WA
Other
Enumeration date
03/14/2006
Last updated
05/03/2022
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