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Individual

DR. PETER B WILTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1655 BEAM AVE STE 302, MAPLEWOOD, MN 55109
(651) 227-6351
Mailing address
310 SMITH AVE N, SAINT PAUL, MN 55102-2383
(952) 843-4333
(952) 843-4301

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
29713
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
086278900
MN
Enumeration date
02/20/2006
Last updated
06/19/2018
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