Individual
MRS. PATRICIA J WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
21559
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51077860
BCBS OF AL
AL
Enumeration date
01/03/2006
Last updated
12/05/2007
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