Individual
JANE ELLEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
900 CATON AVE, MAILBOX 081, BALTIMORE, MD 21229-5201
(443) 703-3200
(443) 703-3201
Mailing address
3501 SINCLAIR LN, BALTIMORE, MD 21213-2029
(410) 732-8800
(410) 534-2392
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0061584
MD
2083P0901X
Public Health & General Preventive Medicine Physician
D0061584
MD
Other
Enumeration date
02/21/2008
Last updated
11/10/2015
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