Individual
DR. MATTHEW MCEWEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER DR, PALLIATIVE MEDICINE, LEBANON, NH 03756-1000
(603) 650-5402
Mailing address
1 MEDICAL CENTER DR, PALLIATIVE MEDICINE, LEBANON, NH 03756-1000
(603) 650-5402
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
052321
CO
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
17741
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024584
KAISER COMMERCIAL NUMBER
CO
05
—
26357232
—
CO
Enumeration date
04/07/2010
Last updated
07/26/2016
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