Individual
SUSANNA S. WILKENS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 ELLIOT WAY, HOSPITALIST PROGRAM - ELLIOT HOSPITAL, MANCHESTER, NH 03103-3502
(603) 663-2271
(603) 663-2273
Mailing address
1 ELLIOT WAY, HOSPITALIST PROGRAM - ELLIOT HOSPITAL, MANCHESTER, NH 03103-3502
(603) 663-2271
(603) 663-2273
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7641
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0105247Y0NH02
ANTHEM ACES #
NH
01
—
0407215
UNITED HC
NH
01
—
2064
CIGNA PIN
NH
05
—
30200028
—
NH
01
—
3206430
AETNA PIN
NH
01
—
406461
TUFTS PIN
NH
01
—
E52438
ANTHEM REFERRING UPIN
NH
01
—
P00014363
RR MEDICARE
NH
Enumeration date
03/17/2006
Last updated
07/09/2007
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