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Individual

DANIEL WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
130 FISHER RD, BERLIN, VT 05602-9516
(802) 371-4100
Mailing address
130 FISHER RD, PO BOX 547, BERLIN, VT 05602-9516
(802) 371-4100

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
032-0000500
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
OVN2743
VT
Enumeration date
07/19/2006
Last updated
06/18/2011
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