Individual
STEVEN W WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1900 ELECTRIC RD, SALEM, VA 24153-7474
(540) 776-4970
Mailing address
12 GILL ST, WOBURN, MA 01801-1728
(781) 937-4522
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110840558
VA
Other
Enumeration date
06/15/2006
Last updated
04/11/2008
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