Individual
DR. BRANDON DANIEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 WHEELING AVE, GLEN DALE, WV 26038-1660
(304) 845-3211
Mailing address
222 NEWBERRY LN, MORGANTOWN, WV 26505-1078
(304) 281-8551
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
29198
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2017
Last updated
04/07/2022
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