Individual
DR. JUSTIN B. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. FACP
Contact information
Practice address
59 KOCH AVE, MORRIS PLAINS, NJ 07950-4400
(973) 538-1800
(973) 889-8486
Mailing address
527 WAKEFIELD DR, METUCHEN, NJ 08840-1625
(973) 538-1800
(973) 889-8486
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
204521
NY
207R00000X
Internal Medicine Physician
Primary
MA062314
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6567207
—
NJ
01
—
776501-B1J
MEDICARE BILLING NUMBER
NJ
Enumeration date
02/03/2006
Last updated
03/05/2015
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