Individual
DR. TIHESHA L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3641 S MIAMI AVE, SUITE 331, MIAMI, FL 33133-4205
(305) 285-5040
(305) 285-5039
Mailing address
3641 S MIAMI AVE, SUITE 331, MIAMI, FL 33133-4205
(305) 285-5040
(305) 285-5039
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
054703
GA
208600000X
Surgery Physician
Primary
D0067673
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942236
AETNA PPO
—
05
—
4153308
—
MD
01
—
58860013
CAREFIRST BLE CHOICE
—
01
—
7224577
AETNA HMO
—
05
—
767420679A
—
GA
01
—
K313BR94043801
CAREFIRST MARYLAND
—
Enumeration date
01/17/2006
Last updated
06/17/2011
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