Individual
MR. BENJAMIN FREDERICK WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MAINE MEDICAL CENTER, 22 BRAMHALL STREET, PORTLAND, ME 04102
(207) 662-0111
Mailing address
96 APPLECREST DR, YARMOUTH, ME 04096-8311
(757) 470-1925
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
0101270233
VA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/25/2019
Last updated
06/06/2024
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