Individual
SHANDRA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8200 E BELLEVIEW AVE STE 100E, GREENWOOD VILLAGE, CO 80111-2804
(303) 649-3710
(303) 649-3711
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
41060
CO
208800000X
Urology Physician
Primary
DR.0041060
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26525267
—
CO
Enumeration date
07/26/2006
Last updated
10/13/2020
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