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Individual

GRANT WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1800 ORLEANS ST, BALTIMORE, MD 21287-0010
(410) 955-5000
Mailing address
6201 GREENLEIGH AVE, BALTIMORE, MD 21220-2004
(410) 933-6423

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0106071
MD
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
01/23/2021
Last updated
03/26/2026
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