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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | John Wilson | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| Description | License No: D44833 | [sources] | |||
| First name | John | [sources] | |||
| Last name | Wilson | [sources] | |||
| NPI | 1639277882 | [sources] | |||
| Sector | MD | [sources] | |||
| Address | 360 E PULASKI HWY, STE 2A, ELKTON, ELKTON, MD 21921-0000 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers deemed ineligible to participate in Maryland's Medicaid program.
United States · MDH
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