Individual
MARK R WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5315 ELLIOTT DR, SUITE 202, YPSILANTI, MI 48197-8634
(734) 712-0600
(734) 712-0522
Mailing address
24 FRANK LLOYD WRIGHT DR, PO BOX 0446 LOBBY J, ANN ARBOR, MI 48105-9484
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
MW046336
MI
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
4301046336
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101918045
—
MI
Enumeration date
06/14/2006
Last updated
12/05/2016
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