Individual
ANDREW WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 W. 13 MILE RD, 400 FSC-PCS, ROYAL OAK, MI 48073
(248) 423-2481
Mailing address
3601 W. 13 MILE RD, 400 FSC-PCS, ROYAL OAK, MI 48073
(248) 423-2481
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301030680
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1577886
—
MI
Enumeration date
03/24/2006
Last updated
07/08/2007
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