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Individual

DR. BRUCE EDWARD WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
925 STEVENS DR STE 2E, RICHLAND, WA 99352-3523
(509) 940-9052
(590) 940-9054
Mailing address
925 STEVENS DR STE 2E, RICHLAND, WA 99352-3523
(509) 940-9052
(590) 542-8095

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
0023055
WA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD00023055
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0023055
STATE LICENSE
WA
05
121374
WA
Enumeration date
09/27/2006
Last updated
01/27/2020
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