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NPI Code Detail

MEDICARE: DR. CLAIRE MARIE WILSON M.D.

MEDICARE:  DR. CLAIRE MARIE WILSON  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080P0206XPediatric Gastroenterology PhysicianG45530CA
22080P0206XPediatric Gastroenterology Physician7027AK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457333247
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CLAIRE MARIE WILSON M.D.
Provider Business Mailing Address
First Line : PO BOX 4105
Second Line :
City : PORTLAND
State : OR
Zip : 97208-4105
Country : US
Telephone Number : 866-907-1067
Fax Number : 425-917-9141
Provider Business Practice Location Address
First Line : 3340 PROVIDENCE DR
Second Line : TOWER A, SUITE 567
City : ANCHORAGE
State : AK
Zip : 99508-4691
Country : US
Telephone Number : 907-212-2240
Fax Number : 907-212-2872
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2005
Last Update Date : 03/03/2016

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Directions to “ DR. CLAIRE MARIE WILSON M.D.” Practice Location

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