Individual
DR. MARC WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
815 E PRATT ST, BALTIMORE, MD 21202-4889
(410) 637-5700
(410) 637-5661
Mailing address
PO BOX 64888, BALTIMORE, MD 21264-4888
(800) 889-4939
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
D46771
MD
207Q00000X
Family Medicine Physician
Primary
D46771
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
493150500
—
MD
Enumeration date
07/07/2006
Last updated
11/19/2021
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