Organization
MATTHEW WILSON LLC
Active
Organization
MATTHEW WILSON LLC
Active
Other names
Matthew Wilson, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW STEWART WILSON M.D. (MEMBER)
(314) 251-7720
Entity
Organization
Contact information
Practice address
621 S NEW BALLAS RD, TOWER A, SUITE 398, SAINT LOUIS, MO 63141-8232
(314) 251-7720
(314) 251-7722
Mailing address
621 S NEW BALLAS RD, TOWER A, SUITE 398, SAINT LOUIS, MO 63141-8232
(314) 251-7720
(314) 251-7722
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2008006048
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649392796
NPI MATTHEW S. WILSON MD
MO
Enumeration date
04/15/2008
Last updated
04/15/2008
Update your record
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