Wilson, Mark Meredith

Wilson, Mark Meredith is an individual health care provider with primary practice located at 55 Lake Ave N Department Of Pulmonary Medicine, Worcester MA 01655-0002. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Wilson, Mark Meredith can be contacted via phone (508) 856-3121.

Contact Information

Primary practice address
55 Lake Ave N Department Of Pulmonary Medicine Worcester MA 01655-0002
Phone: (508) 856-3121
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 72519 Massachusetts

Profile Details

NPI number 1346224102
LBN Legal business name Wilson, Mark Meredith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2005
Last updated Nov 2nd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346224102 NPPES
Massachusetts MEDICAID 110051153A

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