Individual
ROBERT F WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4160 JOHN R ST, STE 615, DETROIT, MI 48201-2020
(313) 745-4195
(313) 993-8669
Mailing address
1420 STEPHENSON HWY, SUITE 400 - CREDENTIALING, TROY, MI 48083-1189
(248) 581-5974
(248) 581-5640
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301023556
MI
2086S0102X
Surgical Critical Care Physician
4301023556
MI
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
4301023556
MI
Other
Enumeration date
06/06/2006
Last updated
02/06/2014
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