Individual
MS. MELANIE L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 HOSPITAL DR, SPENCER, WV 25276-1050
(304) 927-6822
(304) 927-6873
Mailing address
200 HOSPITAL DR, SPENCER, WV 25276-1050
(304) 927-6822
(304) 927-6873
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
669
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810000833
—
WV
Enumeration date
06/09/2005
Last updated
05/18/2023
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