Individual
DR. MARK E WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
280 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(303) 861-3451
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
27001
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004370
KAISER-COMMERCIAL NUMBER
—
Enumeration date
02/16/2007
Last updated
10/30/2007
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