Provider Demographics
NPI:1023334273
Name:WILSON, PARIA MAJD (MD)
Entity type:Individual
Prefix:
First Name:PARIA
Middle Name:MAJD
Last Name:WILSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PARIA
Other - Middle Name:ESMAILY
Other - Last Name:MAJD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML 2008
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-7966
Mailing Address - Fax:513-636-7967
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 2008
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-7966
Practice Address - Fax:513-636-7967
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1205512080P0204X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0095321Medicaid