Individual
DR. MYRA L. WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-0027
(570) 271-6338
(570) 271-6105
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
MD060006L
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD060006L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001747485
—
PA
Enumeration date
05/16/2006
Last updated
08/05/2020
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