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1629062211
LARRY A WILSON
BALTIMORE, MD
NPI
1629062211
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MD D26253)
Enumeration Date
2005-09-09
Last Update Date
2018-03-27
Business Address
LARRY A WILSON MD
4924 CAMPBELL BLVD
BALTIMORE, MD 21236-5908
Phone number: 443-461-1997
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Mailing Address
LARRY A WILSON MD
PO BOX 759047
BALTIMORE, MD 21275-9047
Phone number: 804-968-5700
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