Individual
MINNIE LEIGH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
1800 ORLEANS ST, BALTIMORE, MD 21287-0010
(410) 955-4846
Mailing address
4100 BROADWAY AVE APT 10103, FLOWER MOUND, TX 75028-7667
(903) 744-9270
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
01/14/2019
Last updated
03/06/2019
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