Individual
DR. STUART D WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, SURGICAL ONCOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-5020
(414) 805-5771
Mailing address
9200 W WISCONSIN AVE, SURGICAL ONCOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-5020
(414) 805-5771
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
14144
WI
2086X0206X
Surgical Oncology Physician
Primary
14144
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000138R
HUMANA
—
05
—
1902858418
—
WI
05
—
30874600
—
WI
Enumeration date
05/16/2006
Last updated
11/09/2012
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