Wilson, Mark W.

Wilson, Mark W. is an individual health care provider with primary practice located at 1001 Potrero Avenue Sfgh Department Of Radiology, Room 1X57, San Francisco CA 94110-2204. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Wilson, Mark W. can be contacted via phone (415) 353-1300.

Contact Information

Primary practice address
1001 Potrero Avenue Sfgh Department Of Radiology, Room 1X57 San Francisco CA 94110-2204
Phone: (415) 353-1300
Fax: (415) 353-8570
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G74073 California
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X G74073 California

Profile Details

NPI number 1184666091
LBN Legal business name Wilson, Mark W.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Jul 23rd, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184666091 NPPES
California MEDICAID 00G740730

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