| Doctor Name: | ETHEL A WILSON |
| NPI Number: | 1467605089 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD, MS, LDN |
| License Number: | D01601 |
| Business Practice Address: | 11110 Medical Campus Rd Suite 108 Hagerstown, MD - 217426700 |
| Business Phone Number: | 3017144041 |
| Business Fax Number: | 3017144351 |
| Mailing Address: | 11110 Medical Campus Rd, Suite 108 HAGERSTOWN |
| State: | MD |
| Postal Code: | 217426700 |
| Phone Number: | 3017144041 |
| Fax Number: | 3017144351 |
| NPI Enumeration Date: | 10/28/2008 |
| NPI Last Update Date: | 11/17/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | D01601 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |