Individual
CHARLES STEPHEN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1500 S 48TH ST, LINCOLN, NE 68506-1225
(402) 481-8944
Mailing address
7430 N HAMPTON RD, LINCOLN, NE 68506-1624
(402) 488-9181
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
12283
NE
Other
Enumeration date
06/18/2007
Last updated
07/08/2007
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