Individual
MR. GREGORY S. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
8028 RITCHIE HWY, SUITE # 311, PASADENA, MD 21122-1075
(410) 590-9462
(410) 590-9464
Mailing address
8028 RITCHIE HWY, SUITE # 311, PASADENA, MD 21122-1075
(410) 590-9462
(410) 590-9464
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
00658
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
413159200
—
MD
01
—
8632
BLUE CHOICE GROUP
MD
01
—
86RVHE
CAREFIRST GROUP
MD
Enumeration date
08/25/2006
Last updated
04/03/2014
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