Individual
ROBERT H WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 CEDAR ST SE, SUITE 6600, ALBUQUERQUE, NM 87106-4917
(505) 724-4300
(505) 724-4384
Mailing address
201 CEDAR ST SE, SUITE 6600, ALBUQUERQUE, NM 87106-4917
(505) 724-4300
(505) 724-4384
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
92-377
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E6907
—
NM
Enumeration date
01/05/2006
Last updated
01/10/2013
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