Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 56941 | CT |
Y | 207RX0202X | Medical Oncology | 56941 | CT |
NPI | 1427258078 |
---|---|
Provider Name | Frederick H Wilson |
First Address | New Haven, CT 06510 |
Second Address | New Haven, CT 06510-3220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2007 |
Last Update Date | 08/09/2017 |