Individual
DR. RICHARD P WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
840 WALNUT ST, STE 1120, PHILA, PA 19107-5109
(215) 928-3204
(484) 434-2793
Mailing address
PO BOX 7780-1679, PHILA, PA 19182-0001
(610) 660-0446
(484) 434-2793
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MA03501600
NJ
207W00000X
Ophthalmology Physician
Primary
MD017251E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3462609
—
NJ
Enumeration date
02/16/2006
Last updated
07/08/2007
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