NPI 1003347576

Brandon Daniel Wilson, MD

Practitioner General Practice Physician Glen Dale, WV

Practice location

Address: 800 Wheeling Ave, Glen Dale, WV 26038-1660
Phone: (304) 845-3211
Mailing address: 222 Newberry Ln, Morgantown, WV 26505-1078

Registered specialties (2)

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 29198 (WV)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1003347576
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Mar 2017
Record last updated: 7 Apr 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.