Individual
DR. SCOTT NUMO WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5 LONGFELLOW PL, SUITE 213, BOSTON, MA 02114-2839
(617) 964-7309
(617) 742-6954
Mailing address
5 LONGFELLOW PL, SUITE 213, BOSTON, MA 02114-2839
(617) 964-7309
(617) 742-6954
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
51507
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051507
TUFTS
MA
01
—
J03672
BCBS MA
MA
Enumeration date
10/26/2005
Last updated
07/08/2007
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