Individual
DR. JUSTIN NATHANIEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
555 N DUKE ST, LANCASTER, PA 17602-2250
(717) 299-4173
(717) 295-4773
Mailing address
555 N DUKE ST, LANCASTER, PA 17602-2250
(717) 299-4173
(717) 295-4773
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
105363
CA
2085R0202X
Diagnostic Radiology Physician
Primary
MD439851
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001733443
—
PA
05
—
102702014
—
PA
Enumeration date
09/23/2008
Last updated
09/26/2024
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