Individual
DR. WILSON ZACHARY RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1044 N MASON RD, DEPT NEUROLOGICAL SURGERY, STE 110, SAINT LOUIS, MO 63141-6431
(314) 362-3577
(314) 362-2107
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-3577
(314) 362-2107
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
2009008004
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206638702
—
MO
Enumeration date
09/06/2006
Last updated
04/17/2025
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