Individual
STEVEN KARL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
81719 DR CARREON BLVD, POD C, INDIO, CA 92201-5518
(760) 342-6657
(760) 342-6658
Mailing address
2051 SE 3RD ST, UNIT 401, DEERFIELD BEACH, FL 33441-5197
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
C51286
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C512861
PPIN
CA
Enumeration date
08/04/2005
Last updated
07/08/2007
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