Provider Demographics
NPI:1679563589
Name:WILKINSON, HAROLD A (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:A
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-3776
Mailing Address - Fax:617-643-7963
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:WAC 745
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-3776
Practice Address - Fax:617-643-7963
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2014-09-16
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Provider Licenses
StateLicense IDTaxonomies
MA27355207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0193585Medicaid
MA703571OtherTUFTS HEALTH PLAN
MAM06027OtherBCBS MA
MAM06027Medicare PIN
MAM06027OtherBCBS MA