Wilson, Sean M

Wilson, Sean M is an individual health care provider with primary practice located at 1501 San Pedro Dr Se , Albuquerque NM 87108-5153. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Wilson, Sean M can be contacted via phone (505) 265-1711.

Contact Information

Primary practice address
1501 San Pedro Dr Se Albuquerque NM 87108-5153
Phone: (505) 265-1711
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA2005-0035 New Mexico

Profile Details

NPI number 1386703478
LBN Legal business name Wilson, Sean M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2006
Last updated Dec 7th, 2012 - about 13 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 1386703478 NPPES
Other 202005611 PRESBYTERIAN HEALTH PLANS
Other 10022311 PRESBYTERIAN HEALTH PLANS
Other QMYPR0072546 PRESBYTERIAN HEALTH PLANS
MEDICAID 35377313 PRESBYTERIAN HEALTH PLANS

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