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NPI Code Detail

MEDICARE: REBECKA AMANDA WILSON DO

MEDICARE: REBECKA AMANDA WILSON DO
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
1390200000XStudent in an Organized Health Care Education/Training ProgramC7-0019192DE

General Provider Information

NPI Number : 1346177425
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECKA AMANDA WILSON DO
Provider Business Mailing Address
First Line : 1600 ROCKLAND RD STE 3D16
Second Line :
City : WILMINGTON
State : DE
Zip : 19803-3607
Country : US
Telephone Number : 302-651-5874
Fax Number : 302-651-5954
Provider Business Practice Location Address
First Line : 1600 ROCKLAND RD STE 3D16
Second Line :
City : WILMINGTON
State : DE
Zip : 19803-3607
Country : US
Telephone Number : 302-651-5874
Fax Number : 302-651-5954
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2026
Last Update Date : 05/05/2026

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