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Individual

BONITA WESLEY WILSON

Active
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Individual

BONITA WESLEY WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M. D.

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
0101038231
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002784A38
MEDICARE PTAN
VA
05
—
010026610
—
VA
01
—
010061
VA PREMIER
VA
01
—
02-00285
UNITED HEALTHCARE
VA
01
—
102827
BLUE CROSS
VA
01
—
229825
SOUTHERN HEALTH
VA
01
—
3389897
AETNA
VA
01
—
4053750
AETNA
VA
01
—
561249571
VA HEALTH NETWORK
VA
01
—
56124971
SENTARA
VA
01
—
597372
ALLIANCE/MAMSI
VA
01
—
D17963
CIGNA
VA
01
—
J063-0002
CAREFIRST
VA
Enumeration date
10/27/2005
Last updated
03/24/2026
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