Organization
SUSAN WALTER WILSON, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN WALTER WILSON MD (OWNER)
(317) 567-2180
Entity
Organization
Contact information
Practice address
9899 E 126TH ST, FISHERS, IN 46038-2821
(317) 567-2180
(317) 567-2191
Mailing address
PO BOX 3041, INDIANAPOLIS, IN 46206-3041
(317) 614-9641
(317) 713-1261
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100237890
—
IN
Enumeration date
04/30/2008
Last updated
01/11/2010
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