Wilson, Deric Michael

Wilson, Deric Michael is an individual health care provider with primary practice located at 1010 Plymouth Rd , York PA 17402-3864. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Wilson, Deric Michael can be contacted via phone (717) 851-1800.

Contact Information

Primary practice address
1010 Plymouth Rd York PA 17402-3864
Phone: (717) 851-1800
Fax: (717) 851-1810
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS014303 Pennsylvania
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OT014074 Pennsylvania

Profile Details

NPI number 1770649378
LBN Legal business name Wilson, Deric Michael
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2006
Last updated Aug 8th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770649378 NPPES
Pennsylvania MEDICAID 102915087

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