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Individual

CAROLYN ALICE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
304 HANCOCK ST, BANGOR VA CLINIC, BANGOR, ME 04401
(207) 561-3600
(207) 947-1862
Mailing address
304 HANCOCK ST, BANGOR VA CLINIC, BANGOR, ME 04401
(207) 561-3600
(207) 947-1862

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
016114
ME
207R00000X
Internal Medicine Physician
120975
NC

Other

Enumeration date
08/15/2006
Last updated
07/08/2007
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