Provider Demographics
NPI:1821895640
Name:WILSON, FREDRICK SHERON
Entity type:Individual
Prefix:
First Name:FREDRICK
Middle Name:SHERON
Last Name:WILSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E WILBETH RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44301-2558
Mailing Address - Country:US
Mailing Address - Phone:216-269-9023
Mailing Address - Fax:
Practice Address - Street 1:120 E WILBETH RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44301-2558
Practice Address - Country:US
Practice Address - Phone:216-269-9023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker