Individual
EARL WESLEY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 SPRUCE ST, PHILA, PA 19107-6130
(215) 829-5664
Mailing address
15 CREST AVE, MALVERN, PA 19355-2610
(610) 733-4545
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
040301E
PA
Other
Enumeration date
05/25/2006
Last updated
04/05/2021
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