Organization
NEAL WILSON M.D. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN NEAL WILSON M.D. (PRESIDENT)
(313) 874-5735
Entity
Organization
Contact information
Practice address
3011 W GRAND BLVD, 573, DETROIT, MI 48202-3096
(313) 874-5735
(313) 874-4197
Mailing address
3011 W GRAND BLVD, 573, DETROIT, MI 48202-3096
(313) 874-5735
(313) 874-4197
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
31392
MI
261QA1903X
Ambulatory Surgical Clinic/Center
AWO31392
MI
Other
Enumeration date
03/19/2008
Last updated
03/19/2008
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