Individual
DR. STEPHEN WILSON
Active
Individual
DR. STEPHEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
SW061846
MI
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
SW061846
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932129319
DMENSION
MI
01
—
2505012031
BCBS OF MI
MI
05
—
4332250
—
MI
05
—
4332250 10
—
MI
01
—
540E019050
BCBSM DME
MI
01
—
5614160001
MC NCS
MI
Enumeration date
06/20/2005
Last updated
07/23/2008
Update your record
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