Individual
DR. KIM A WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
75 BICKFORD ST, MARTHA ELIOT HEALTH CENTER, JAMAICA PLAIN, MA 02130-1401
(617) 971-2312
Mailing address
63 CLAYPIT HILL RD, WAYLAND, MA 01778-2004
(508) 358-7841
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
76388
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3150620
—
MA
Enumeration date
11/24/2006
Last updated
07/08/2007
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