Individual
WILNER SAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
98 MAIN ST, SOUTHINGTON, CT 06489-2500
(860) 276-5144
(860) 276-5148
Mailing address
98 MAIN ST, SOUTHINGTON, CT 06489-2500
(860) 276-5144
(860) 276-5148
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
041729
CT
207RN0300X
Nephrology Physician
041729
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417296
—
CT
Enumeration date
06/30/2005
Last updated
02/26/2016
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