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Individual

NORMAN E WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2526
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
008926
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
008926
ANTHEM
ME
05
279800099
ME
05
30201156
NH
01
3240685
AETNA
ME
01
M4870
CIGNA
ME
01
MN3469
HPHC
ME
Enumeration date
11/14/2006
Last updated
07/29/2009
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