Individual
MR. ANDREW DALTON WILKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
100 HOSPITAL RD STE 2A, LEOMINSTER, MA 01453-2253
(978) 466-2692
Mailing address
12 STODDARD DR, WORCESTER, MA 01604-1331
(646) 369-2548
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2328128
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN2328128
RN AND NP LICENSE NUMBER
MA
Enumeration date
10/27/2021
Last updated
10/27/2021
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