Individual
MR. TED LEWIS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIANS ASSISTANT
Contact information
Practice address
7210 WINDSOR BLVD, RUTHERFORD BUSINESS CENTER, BALTIMORE, MD 21244-2633
(410) 597-7438
(410) 597-7722
Mailing address
7210 WINDSOR BLVD, RUTHERFORD BUSINESS CENTER, BALTIMORE, MD 21244-2633
(410) 597-7438
(410) 597-7722
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C00001109
MD
Other
Enumeration date
04/04/2008
Last updated
04/04/2008
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