Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shontray Bernard Wilson, PA

Individual provider Physician Assistant · NPI 1093601346

Shontray Bernard Wilson, PA is a Physician Assistant in Birmingham, Alabama. Licensed in Alabama. Registered with an NPI since 2025.

Licensed in
AL
In the registry since
2025
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

619 19th St S
Birmingham, AL 35249-1900
Phone: (205) 239-1623
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2770 (AL)

Record details

NPI number1093601346
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 14, 2025
Last updated in NPPESJuly 8, 2026
Certification dateJuly 8, 2026

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