National Provider Identifier
Ian Jermaine Wilson, M.D.
Ian Jermaine Wilson, M.D. is listed in the NPPES registry with a primary specialty of Diagnostic Radiology Physician in Williamsville, NY and a listed phone number of (716) 631-2500.
Profile Overview
- NPI
- 1871793570
- Provider Type
- Individual
- Primary Specialty
- Diagnostic Radiology Physician
- Enumeration Date
- July 20, 2007
- Last Updated
- February 24, 2025
Practice Location
- 55 Spindrift Dr
- Williamsville, NY 14221-7891
Phone: (716) 631-2500
Mailing Address
- 700 E Morehead St Ste 300
- Charlotte, NC 28202-2742
Specialties
- Diagnostic Radiology Physician (2085R0202X)
- Diagnostic Radiology Physician (2085R0202X)
- Vascular & Interventional Radiology Physician (2085R0204X)
Full Record
- NPI
- 1871793570
- Entity Type
- Individual
- Last Name
- Wilson
- First Name
- Ian
- Middle Name
- Jermaine
- Name Prefix
- Dr.
- Credential
- M.D.
- Mailing Street Address
- 700 E Morehead St Ste 300
- Mailing City
- Charlotte
- Mailing State
- NC
- Mailing ZIP Code
- 28202-2742
- Mailing Country
- US
- Practice Street Address
- 55 Spindrift Dr
- Practice City
- Williamsville
- Practice State
- NY
- Practice ZIP Code
- 14221-7891
- Practice Country
- US
- Practice Phone
- (716) 631-2500
- Enumeration Date
- July 20, 2007
- Last Updated
- February 24, 2025
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- February 24, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Diagnostic Radiology Physician (2085R0202X), Diagnostic Radiology Physician (2085R0202X), Vascular & Interventional Radiology Physician (2085R0204X)
- Other Identifiers
- 02933948 (NY)