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
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