Dr. Mark D Wilson, M.D.
Otolaryngology in Rancho Mirage, CA. Individual provider (NPI-1).
NPI number1376535708
StatusActive
Last updated in NPPESJun 26, 2015
Details
- NPI
- 1376535708
- Entity type
- Individual (NPI-1)
- Name
- Dr. Mark D Wilson
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 22, 2005
- Last updated
- Jun 26, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Y00000X | Otolaryngology | C135134 | CA | Yes |
| 207Y00000X | Otolaryngology | 4301063104 | MI |
Practice location
39000 Bob Hope DrWright Bldg #301
Rancho Mirage, CA 92270-3221
Phone 760-340-4566 · Fax 760-340-2481
Mailing address
39000 Bob Hope DrWright Bldg #301
Rancho Mirage, CA 92270-3221
Phone 760-340-4566 · Fax 760-340-2481
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