Individual
ROBERT B WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE STREET, PHILADELPHIA, PA 19104
(215) 662-6503
Mailing address
3400 SPRUCE STREET, PHILADELPHIA, PA 19104
Taxonomy
Speciality
Code
Description
License number
State
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
Primary
MD045632L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015675670001
—
PA
Enumeration date
06/15/2006
Last updated
05/13/2011
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