Individual
DR. BRUCE LEONARD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.S.P.H
Contact information
Practice address
10200 CHEF MENTEUR HWY STE A, NEW ORLEANS, LA 70127-4264
(504) 603-6190
Mailing address
10200 CHEF MENTEUR HWY STE A, NEW ORLEANS, LA 70127-4264
(504) 603-6190
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
25MA09945200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22-3052989
TAX ID#
NJ
Enumeration date
08/27/2010
Last updated
11/14/2025
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