Female

Dr. Shacara Wilson M.D.

Family Medicine Physician in St Petersburg, FL(View on Map)

Full Name

Dr. Shacara Wilson M.D.

NPI Number

1194014621

NPI Type

Individual Provider

Gender

Female

Enumeration Date

04/05/2011

Specialties

(Taxonomies)

Code

207Q00000X

Primary Taxonomy

Yes

Licenses

State

Florida
Florida

License Number

ME113623
TR15398

Contact
Information

Purpose

Mailing
Location

Address

701 6TH ST S
701 6TH ST S

City

St Petersburg
St Petersburg

State

FL
FL

Postal Code

33701-4814
33701-4814

Country

US
US

Telephone Number

(727) 893-6116
(727) 893-6116

Identifiers

Identifier

105519500

Identifier State

FL

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/30/2020

Provider Address

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