Robert B Wilson, MD

Primary specialty

Molecular Genetic Pathology (Pathology) PhysicianTaxonomy code 207ZP0007X

License

MD045632L Issued in PA

Practice address

3400 Spruce Street
Philadelphia, PA 19104

Phone

(215) 662-6503

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Penn-Medical Group

  • Gynecologic Oncology Physician
  • Philadelphia, PA
  • NPI 1235527342
  Medicare reassignment NPD
• University of Penn-Medical Group

  • Anatomic Pathology & Clinical Pathology Physician
  • Philadelphia, PA
  • NPI 1700274727

  Molecular Genetic Pathology

  NPD
• University of Penn-Medical Group

  • Surgical Oncology Physician
  • Philadelphia, PA
  • NPI 1871981985
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305244800000",
    "number": "1306880265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-6503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROBERT",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2011-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0007X",
            "taxonomy_group": "",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": "PA",
            "license": "MD045632L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015675670001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regina Wilson
• Regina Wilson, ATC
• Renata O. Wilson, MD
• Renee Wilson
• Richard Smith Wilson Jr., DMD
• Robert D Wilson, M.D.
• Rodgers M Wilson, M.D.
• Roniche Wilson
• Rosemary Elizabeth Wilson
• Sarah Elizabeth Landis Wilson, D.O.

• Molecular Genetic Pathology (Pathology) Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Molecular Genetic Pathology (Pathology) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.