Individual
MARGARET M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3660 VISTA AVE, SAINT LOUIS, MO 63110-2540
(314) 977-8462
(314) 268-5108
Mailing address
3691 RUTGER ST, PROVIDER ENROLLMENT, SAINT LOUIS, MO 63110-2515
(314) 977-6828
(314) 977-6777
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
2000153664
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126692
BCBS
—
01
—
234125
HARMONY
—
01
—
449182
HEALTHLINK
—
01
—
4553038
AETNA
—
01
—
75334
HEALTH ALLIANCE
—
Enumeration date
08/04/2006
Last updated
07/08/2007
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