Individual
MATTHEW Z WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
ONE MEDICAL CENTER DRIVE, LEBANON, NH 03756-0001
(603) 650-8113
Mailing address
ONE MEDICAL CENTER DRIVE, LEBANON, NH 03756-0001
(603) 650-8113
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
18380
NH
208600000X
Surgery Physician
MT195178
PA
208C00000X
Colon & Rectal Surgery Physician
18380
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031470
—
VT
05
—
3109671
—
NH
Enumeration date
05/22/2009
Last updated
06/26/2019
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