Provider Demographics
NPI:1073774576
Name:WILSON, MARGARET L (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:L
Last Name:WILSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 ANDES RD
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:NY
Mailing Address - Zip Code:13753-7407
Mailing Address - Country:US
Mailing Address - Phone:607-746-0550
Mailing Address - Fax:607-746-0568
Practice Address - Street 1:460 ANDES RD
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:NY
Practice Address - Zip Code:13753-7407
Practice Address - Country:US
Practice Address - Phone:607-746-0550
Practice Address - Fax:607-746-0568
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2011-0567207Q00000X, 208M00000X
390200000X
NY317041207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program