Individual
DAVID B WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 IRMC DR, SUITE 160, INDIANA, PA 15701-3674
(724) 465-2676
(724) 349-1830
Mailing address
640 KOLTER DR, INDIANA, PA 15701-3570
(724) 357-7333
(724) 465-0193
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD065847L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017454620003
—
PA
01
—
CI1160
RAILROAD MEDICARE
PA
Enumeration date
03/25/2006
Last updated
10/01/2019
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