Individual
DR. BRENDA A WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3601 A ST, ERIE AVE & FRONT ST, PHILADELPHIA, PA 19134-1043
(215) 427-5000
Mailing address
1086 W KING RD, CHESTNUT 213, MALVERN, PA 19355-1975
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MT180578
PA
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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