Organization
GREGORY B. WILSON, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY B WILSON M.D. (PHYSICIAN)
(808) 735-9093
Entity
Organization
Contact information
Practice address
1329 LUSITANA ST, SUITE 604, HONOLULU, HI 96813-2429
(808) 531-1116
Mailing address
1329 LUSITANA ST, SUITE 604, HONOLULU, HI 96813-2429
(808) 531-1116
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD-03515
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A0051910
HMSA
HI
05
—
04569301
—
HI
Enumeration date
07/16/2012
Last updated
07/16/2012
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