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NPI Code Detail

MEDICARE: DR. JUSTIN B. WILSON M.D. FACP

MEDICARE: DR. JUSTIN B. WILSON M.D. FACP
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
1207R00000XInternal Medicine PhysicianMA062314NJ
2207R00000XInternal Medicine Physician204521NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2776501-B1JOTHERNJMEDICARE BILLING NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831161850
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUSTIN B. WILSON M.D. FACP
Provider Business Mailing Address
First Line : 527 WAKEFIELD DR
Second Line :
City : METUCHEN
State : NJ
Zip : 08840-1625
Country : US
Telephone Number : 973-538-1800
Fax Number : 973-889-8486
Provider Business Practice Location Address
First Line : 59 KOCH AVE
Second Line :
City : MORRIS PLAINS
State : NJ
Zip : 07950-4400
Country : US
Telephone Number : 973-538-1800
Fax Number : 973-889-8486
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 03/05/2015

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