Wilson, Renee

Wilson, Renee is an individual health care provider with primary practice located at 235 N Pearl St , Brockton MA 02301-1794. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Wilson, Renee can be contacted via phone (508) 427-2090.

Contact Information

Primary practice address
235 N Pearl St Brockton MA 02301-1794
Phone: (508) 427-2090
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 229528 Massachusetts

Profile Details

NPI number 1740275403
LBN Legal business name Wilson, Renee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2005
Last updated Apr 28th, 2017 - about 9 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 1740275403 NPPES
Massachusetts MEDICAID 110075069A

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