Individual
MICHAEL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-8166
Mailing address
3131 NEWMARK DR STE 220, MIAMISBURG, OH 45342-5400
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35.149450
OH
Other
Enumeration date
04/30/2021
Last updated
02/22/2024
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