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Dwayne Wilson

NPI 1891192894 · on the registry since 2014 · sole proprietor

Practice

Address
24455 Lake Shore Blvd
Apt. 1818
Euclid, OH 44123
Phone
(216) 502-0246
Clinicians at this address
5

Registry record

Primary taxonomy
163W00000X
163W00000X
Licence states on file
OH
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2014-11-19

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Ohio