Individual
GREGORY J WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2010015957
MO
207R00000X
Internal Medicine Physician
OS-013257
PA
207RR0500X
Rheumatology Physician
Primary
O-0777
ID
207RR0500X
Rheumatology Physician
OS013257
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101334728
—
PA
05
—
1013347280004
—
PA
05
—
1669406799
—
ID
Enumeration date
07/11/2006
Last updated
06/07/2023
Update your record
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