Individual
JOHN MICHAEL WILSON
Active
Individual
JOHN MICHAEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
4301061808
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538124508
—
MI
05
—
3440997
—
MI
01
—
4301061808
MICHIGAN STATE LICENSE
MI
Enumeration date
04/20/2006
Last updated
06/09/2010
Update your record
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