Individual
ROBERT E. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1240 S CEDAR CREST BLVD, SUITE #307, ALLENTOWN, PA 18103-6218
(610) 402-1757
(610) 402-9089
Mailing address
1245 S CEDAR CREST BLVD, SUITE #301, ALLENTOWN, PA 18103-6258
(610) 402-1757
(610) 402-9089
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
OS007250L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016470690
—
PA
01
—
0123902
CAP. BLUE CROSS
PA
01
—
0377814000
INDEP. BLUE CROSS
PA
01
—
07952776
GATEWAY
PA
01
—
122852
THREE RIVERS
PA
01
—
1654173-002
CIGNA
PA
01
—
2008176
AMERIHEALTH MERCY
PA
01
—
30000037
KEYSTONE MERCY
PA
01
—
814047
AETNA
PA
01
—
952776
KHP CENTRAL
PA
01
—
P2749200
OXFORD
PA
Enumeration date
10/07/2005
Last updated
09/24/2013
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