Individual
KEVIN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
41 MALL RD, BURLINGTON, MA 01805-3220
(781) 744-8000
Mailing address
41 MALL RD, BURLINGTON, MA 01805-0001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
276860
MA
2084N0400X
Neurology Physician
Primary
1013212
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/21/2018
Last updated
05/10/2023
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