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NPI Code Detail

MEDICARE: ANN M WILSON DPM

MEDICARE:   ANN M WILSON  DPM
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
1213E00000XPodiatrist000549MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22700007OTHERMOUNITED HEALTHCARE
3104984OTHERMOBLUE SHIELD OF MISSOURI
4990003939OTHERRR MCR

General Provider Information

NPI Number : 1902911829
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANN M WILSON DPM
Provider Business Mailing Address
First Line : PO BOX 955534
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63195-5534
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 18800 SCHNUCKS DR STE B
Second Line :
City : WARRENTON
State : MO
Zip : 63383-1121
Country : US
Telephone Number : 636-456-3413
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 06/12/2024

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Directions to “ ANN M WILSON DPM” Practice Location

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