Individual
JAMES M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4206
(215) 662-6503
Mailing address
125 S 31ST ST, SUITE 2000 TRL, PHILADELPHIA, PA 19104-3413
(215) 573-9020
(215) 494-5444
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
MD049539L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001478725
—
PA
Enumeration date
07/06/2006
Last updated
12/11/2014
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