Individual
SHONTRAY BERNARD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
619 19TH ST S, BIRMINGHAM, AL 35249-1900
(205) 239-1623
Mailing address
619 19TH ST S, BIRMINGHAM, AL 35249-1900
(205) 239-1623
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/14/2025
Last updated
04/10/2026
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