Individual
MS. ELIZABETH K WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3011 N LINCOLN RD, ESCANABA, MI 49829-9312
(906) 786-6488
(906) 786-6409
Mailing address
3011 N LINCOLN RD, ESCANABA, MI 49829-9312
(906) 786-6488
(906) 786-6409
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101009011
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080052892
RAILROAD MEDICARE
MI
05
—
2966412
—
MI
Enumeration date
09/08/2005
Last updated
02/02/2011
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