Individual
MR. BRIAN S WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7 MARSH BROOK DR STE 205, SOMERSWORTH, NH 03878
(603) 742-2007
Mailing address
789 CENTRAL AVE, DOVER, NH 03820-2526
(603) 740-4478
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1388
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1151272
NCCPA
—
Enumeration date
03/08/2007
Last updated
08/02/2018
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