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NPI Code Detail

MEDICARE: MARSHELYA DENISE WILSON MD

MEDICARE: MARSHELYA DENISE WILSON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician42114TN

General Provider Information

NPI Number : 1730307554
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARSHELYA DENISE WILSON MD
Provider Business Mailing Address
First Line : 1914 CHARLOTTE AVE
Second Line : SUITE 102
City : NASHVILLE
State : TN
Zip : 37203-2198
Country : US
Telephone Number : 615-341-0791
Fax Number : 615-341-0793
Provider Business Practice Location Address
First Line : 601 BENTON AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37204-2303
Country : US
Telephone Number : 615-292-9770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2007
Last Update Date : 05/22/2018

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