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ALICIA MARIE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
211 N EDDY ST, SOUTH BEND, IN 46617-3096
(574) 233-7337
(574) 239-1561
Mailing address
211 N EDDY ST, SOUTH BEND, IN 46617-3096
(574) 233-7337
(574) 239-1561

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
02004821A
IN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/16/2013
Last updated
06/27/2016
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