Individual
MR. ROBERT MAX WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
618 MANZANO NE, ALBUQUERQUE, NM 87110
(505) 220-9583
(505) 925-4354
Mailing address
618 MANZANO NE, ALBUQUERQUE, NM 87110
(505) 220-9583
(505) 925-4354
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/09/2009
Last updated
03/18/2014
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