Individual
DR. BRIAN GUY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
MD.15516R
LA
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
ME82516
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2622203
—
FL
Enumeration date
05/12/2006
Last updated
05/02/2011
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