Individual
THOMAS E WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 EAST MEDICAL CENTER, 2ND FLOOR UNIVERSITY HOSPITAL RECP PATHOLOGY, ANN ARBOR, MI 48109-5054
(800) 862-7284
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
4301074824
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4118896
—
MI
Enumeration date
10/19/2006
Last updated
04/04/2012
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