Individual
DAVID WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
94 OLD SHORT HILLS RD, LIVINGSTON, NJ 07039-5672
(973) 322-5800
Mailing address
PO BOX 1733, FREDERICK, MD 21702-0733
(301) 663-4357
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MA60224
NJ
2085R0202X
Diagnostic Radiology Physician
ME161283
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300107530
RAILROAD MEDICARE
NJ
Enumeration date
06/30/2006
Last updated
02/13/2024
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