Wilson, Roger M

Wilson, Roger M is an individual health care provider with primary practice located at Dorothea Dix Agency , Bangor ME 04401. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Wilson, Roger M can be contacted via phone (207) 944-0733.

Contact Information

Primary practice address
Dorothea Dix Agency Bangor ME 04401
Phone: (207) 944-0733
Fax: (207) 288-3151
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD7254 Maine
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X 007254 Maine

Profile Details

NPI number 1245325794
LBN Legal business name Wilson, Roger M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Jul 9th, 2019 - about 6 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 1245325794 NPPES
Maine MEDICAID 010211483

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