Wilson, Bruce A.
Wilson, Bruce A. is an individual health care provider with primary practice located at 209 Martin Luther King Jr Way , Tacoma WA 98405-4265. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Wilson, Bruce A. can be contacted via phone (253) 596-3300.Contact Information
Primary practice address
209 Martin Luther King Jr Way
Tacoma WA 98405-4265
Phone: (253) 596-3300
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | MD00034129 | Washington |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD00034129 | Washington |
Profile Details
| NPI number | 1982761565 |
|---|---|
| LBN Legal business name | Wilson, Bruce A. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 2nd, 2007 |
| Last updated | May 11th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982761565 | NPPES |
| Washington | MEDICAID | 8193179 |
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