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Contact Information

DWAYNE WILSON, MD
2454 CAMP TRAVIS
FORT SAM HOUSTON, TX78234-7671
 Phone: 401-419-6040
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Aerospace Medicine

2083A0100X 84 Physician/Preventive Medicine
 

Emergency Medical Services

207PE0004X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for DWAYNE WILSON · (Male)

NPI # 1578587341
Status Active
Credentials MD
Entity Individual
Enumeration date 07/26/2006
Last updated 08/07/2010 - About 16 years ago
Sole proprietor 1 Yes
Identifiers
  • CT License # 037212
  • NY License # 210137
  • RI License # 11620
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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