Provider Demographics
NPI:1912272535
Name:WILKINSON, MATTHEW SANKARY (MA)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:SANKARY
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 PEARSON RD # 1
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-1317
Mailing Address - Country:US
Mailing Address - Phone:510-229-9327
Mailing Address - Fax:
Practice Address - Street 1:1120 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5204
Practice Address - Country:US
Practice Address - Phone:510-229-9327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist