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Contact Information

FREDERICK M WILSON, MD
2613 FAIRWAY DR
FULTON, MO65251
 Phone: 573-642-4242
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for FREDERICK M WILSON · (Male)

NPI Number 1609806173
Status Active
Credentials MD
Entity Individual
Enumeration date 07/03/2006
Last updated 02/10/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 113229
  • MO Medicaid 207326307
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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