Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MARK WILSON
Active Sole ProprietorMR. MARK WILSON is a Clinic/Center healthcare provider located in PHILADELPHIA, Pennsylvania. NPI 1750736088 is currently active in the NPPES registry. Verify at CMS.
Clinic/Center · PHILADELPHIA, PA
Registration Details
- NPI Number
- 1750736088
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 23, 2016 (10.326352564809 yrs)
- Last Updated
- Apr 23, 2016
- License
-
A-6418104 (PA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5313 OGDEN STPHILADELPHIA, PA, 191391438Browse PA providers · Browse ZIP 19139
- Phone
- 2156009477
- Fax
- 2159218499
- Primary Specialty
-
Clinic/Center
261Q00000X
Other Clinic/Center Providers in PHILADELPHIA, PA
| Name | Credential | NPI |
|---|---|---|
| JENNIFER JONES | MS., LBS | 1578161147 |
| HANNAH STEVENS | BA | 1144977059 |
| MAILIEN NGUYEN | — | 1639957491 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.