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Individual

MR. MATTHEW C WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1001 20TH ST, HUNTINGTON, WV 25703
(304) 529-6100
(304) 529-0229
Mailing address
1001 20TH ST, HUNTINGTON, WV 25703
(304) 529-6100
(304) 529-0229

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
13029
WV
207KA0200X
Allergy Physician
24827
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0070510000
WV
05
64694763
KY
Enumeration date
07/05/2006
Last updated
09/05/2014
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