Individual
MALLORI MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
U.S. NAVAL HOSPITAL GUAM, AGANA HEIGHTS, GU 96910
(671) 344-9340
Mailing address
PSC 455 BOX 208, FPO, AP 96540-0003
(671) 344-9340
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101273537
VA
207P00000X
Emergency Medicine Physician
M-2478
GU
Other
Enumeration date
02/04/2020
Last updated
06/09/2025
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