Individual provider · Type 1 NPI
Ted Lewis Wilson, PHYSICIANS ASSISTANT
Medical Physician Assistant · Baltimore, MD
NPI number
1063685592
Active
Practice location
7210 Windsor Blvd, Rutherford Business Center
Baltimore, MD 21244-2633
Fax (410) 597-7722
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | C00001109 (MD) |
Medical Physician Assistant: Definition to come...
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About NPI 1063685592
Ted Lewis Wilson, PHYSICIANS ASSISTANT's National Provider Identifier is 1063685592, issued on Apr 4, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Baltimore, MD. The record was last updated on Apr 4, 2008.