Wilson, Stephen

Wilson, Stephen is an individual health care provider with primary practice located at 24345 Harper Ave , St Clair Shores MI 48080. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Wilson, Stephen can be contacted via phone (586) 563-3300.

Contact Information

Primary practice address
24345 Harper Ave St Clair Shores MI 48080
Fax: (586) 563-3313
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X SW061846 Michigan
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X SW061846 Michigan

Profile Details

NPI number 1659376267
LBN Legal business name Wilson, Stephen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Jul 23rd, 2008 - about 17 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 1659376267 NPPES
Michigan MEDICAID 4332250
Michigan Other 5614160001
Michigan Other 2505012031
Michigan MEDICAID 4332250 10
Michigan Other 1932129319
Michigan Other 540E019050

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