# FREDERICK S WILSON DPM INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831274976
- **Authorized official:** DR. FREDRICK SAUL WILSON DPM (PODIATRIST)
- **Authorized official phone:** (510) 796-2191

## Contact information

- **Practice address:** 1895 MOWRY AVE, STE. 103, FREMONT, CA 94538-1737
- **Practice address phone:** (510) 796-2191
- **Practice address fax:** (510) 796-2250
- **Mailing address:** 1895 MOWRY AVE, STE. 103, FREMONT, CA 94538-1737
- **Mailing address phone:** (510) 796-2191
- **Mailing address fax:** (510) 796-2250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | E2105 | CA | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 10/23/2012