Dr Mary M Wilson, MD in Champlin, MN - Medicare Emergency Medicine

Dr Mary M Wilson, MD is a medicare enrolled "Emergency Medicine" physician in Champlin, Minnesota. Her current practice location is 11665 Pondview Ct, Champlin, Minnesota. You can reach out to her office (for appointments etc.) via phone at (763) 421-9387.

Dr Mary M Wilson is licensed to practice in Minnesota (license number 33356) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1992764054.

Contact Information

	Dr Mary M Wilson, MD
	11665 Pondview Ct, Champlin, MN 55316-2629
	(763) 421-9387
	(763) 421-9387

Physician's Profile

Full Name	Dr Mary M Wilson
Gender	Female
Speciality	Emergency Medicine
Location	11665 Pondview Ct, Champlin, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1992764054
Provider Enumeration Date: 03/18/2006
Last Update Date: 11/16/2010

Medicare PECOS Information:

PECOS PAC ID: 7113229295
Enrollment ID: I20160106001715

Medical Identifiers

Medical identifiers for Dr Mary M Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1992764054	NPI	-	NPPES
33356	Other		MN MEDICAL LICENSE
938500200	Medicaid	MN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	33356 (Minnesota)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mary M Wilson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Mary M Wilson, MD 11665 Pondview Ct, Champlin, MN 55316-2629 Ph: (763) 421-9387	Dr Mary M Wilson, MD 11665 Pondview Ct, Champlin, MN 55316-2629 Ph: (763) 421-9387

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Dr Mary M Wilson, MD - Medicare Emergency Medicine in Champlin, MN