Individual
MICHAEL L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 BANNOCK ST, MC 7782, DENVER, CO 80204-4507
(303) 436-6000
Mailing address
777 BANNOCK ST, MC 7782, DENVER, CO 80204-4507
Taxonomy
Speciality
Code
Description
License number
State
207ZM0300X
Medical Microbiology Physician
28412
CO
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
28412
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17353751
—
CO
Enumeration date
08/30/2006
Last updated
05/09/2024
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