Individual
RONALD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 955-6353
Mailing address
PO BOX 64382, BALTIMORE, MD 21264-4382
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R05221
MD
Other
Enumeration date
06/29/2006
Last updated
07/08/2007
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