Individual
BRUMMITTE DALE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3900 N BUFFALO ST, ORCHARD PARK, NY 14127-1842
(716) 656-4494
(716) 648-1552
Mailing address
425 ESSJAY RD STE 170, WILLIAMSVILLE, NY 14221-8235
(716) 630-1219
(716) 817-1726
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
134469
NY
207NS0135X
Procedural Dermatology Physician
1344691
NY
Other
Enumeration date
07/06/2005
Last updated
09/24/2024
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