Provider Demographics
NPI:1366616997
Name:WILSON, DAVID MEYBIN (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MEYBIN
Last Name:WILSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:505 PARNASSUS AVE # M-391
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2204
Mailing Address - Country:US
Mailing Address - Phone:415-443-8799
Mailing Address - Fax:415-476-0616
Practice Address - Street 1:505 PARNASSUS AVE # M-391
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2204
Practice Address - Country:US
Practice Address - Phone:415-443-8799
Practice Address - Fax:415-476-0616
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA959972085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology