Individual
DOUGLAS GREGG WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2220 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1321
(612) 339-3663
(612) 371-1732
Mailing address
8100 34TH AVE S, MAIL STOP 33100A, BLOOMINGTON, MN 55425-1672
(952) 883-5463
(952) 883-5395
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28613
MN
Other
Enumeration date
02/15/2006
Last updated
07/08/2007
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