Provider Demographics
NPI:1578594818
Name:WILKINSON, PETER SCOTT (DO)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:SCOTT
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 PALMER ST STE 2
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619-1305
Mailing Address - Country:US
Mailing Address - Phone:207-454-8233
Mailing Address - Fax:
Practice Address - Street 1:37 PALMER ST STE 2
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:ME
Practice Address - Zip Code:04619-1305
Practice Address - Country:US
Practice Address - Phone:207-454-8233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1158207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine