Neal Wilson M.D. P.C.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

31392 Issued in MI

Legal business name

NEAL WILSON M.D. P.C.

Practice address

3011 W Grand Blvd
573
Detroit, MI 48202-3096

Phone

(313) 874-5735

Fax

(313) 874-4197

NPI assigned

Mar 19, 2008

Last updated

Mar 19, 2008By 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

Dr. Alan Neal Wilson, M.D.

Title

President

Phone

(313) 874-5735

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1720259518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 W GRAND BLVD",
            "address_2": "573",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023096",
            "telephone_number": "313-874-5735",
            "fax_number": "313-874-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 W GRAND BLVD",
            "address_2": "573",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023096",
            "telephone_number": "313-874-5735",
            "fax_number": "313-874-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEAL WILSON M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "NEAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-874-5735",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MI",
            "license": "31392",
            "primary": true
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MI",
            "license": "AWO31392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dena Hisham Nazer, M.D.
• Noma Nazir
• Ncadd-Impact Adolescent Health Center
• Ann Marie Nduati
• Ijeoma Nneka Ndupu, MD
• Kemartha Neal-Doss
• Angela Sue Neal, CPSS
• Dion Lavell Neal
• Ella Lewis Neal, LMSW
• Jacqueline Neal, CHW

• Ambulatory Surgical Clinic/Center in Detroit, MI
• Providers in Detroit, MI by specialty
• Ambulatory Surgical Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; 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.