Brummitte Dale Wilson MD & Associates

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

134469 Issued in NY

Legal business name

BRUMMITTE DALE WILSON MD & ASSOCIATES

Practice address

17 Long Ave Ste 200
Hamburg, NY 14075-6200

Phone

(716) 648-2770

Fax

(716) 646-4642

NPI assigned

Jan 18, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brummitte Dale Wilson

Title

MD

Phone

(716) 648-2770

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457404097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LONG AVE STE 200",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140756200",
            "telephone_number": "716-648-2770",
            "fax_number": "716-646-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 LONG AVE STE 200",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140756200",
            "telephone_number": "716-648-2770",
            "fax_number": "716-646-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUMMITTE DALE WILSON MD & ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BRUMMITTE",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "716-648-2770",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NY",
            "license": "134469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Procedural Dermatology Physician in Hamburg, NY
• Providers in Hamburg, NY by specialty
• Procedural Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.