Dr Mary M Wilson, MD is a
Emergency Medicine physician based in Champlin, Minnesota. Dr Mary M Wilson is licensed to practice in Minnesota (license number 33356) and her current practice location is 11665 Pondview Ct, Champlin, Minnesota. She can be reached at her office (for appointments etc.) via phone at
(763) 421-9387.
NPI number for Dr Mary M Wilson is 1992764054 and her current mailing address is 11665 Pondview Ct, Champlin, Minnesota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1992764054.
Physician's Profile
| Full Name | Dr Mary M Wilson |
|---|
| Gender | Female |
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| Speciality | Emergency Medicine |
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| Location | 11665 Pondview Ct, Champlin, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1992764054
- Provider Enumeration Date: 03/18/2006
- Last Update Date: 11/16/2010
Medical Identifiers
Medical identifiers for Dr Mary M Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1992764054 | NPI | - | NPPES |
| 33356 | Other | | MN MEDICAL LICENSE |
| 938500200 | Medicaid | MN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207P00000X | Emergency Medicine | 33356 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mary M Wilson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Dr Mary M Wilson, MD 11665 Pondview Ct, Champlin, MN 55316-2629 Ph: (763) 421-9387 | Dr Mary M Wilson, MD 11665 Pondview Ct, Champlin, MN 55316-2629 Ph: (763) 421-9387 |
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