Healthcare Provider Details

I. General information

NPI: 1679540165
Provider Name (Legal Business Name): CLARE WILMOT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 08/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 SAINT JOHNSBURY RD SUITE D
LITTLETON NH
03561
US

IV. Provider business mailing address

580 SAINT JOHNSBURY RD STE K
LITTLETON NH
03561-3439
US

V. Phone/Fax

Practice location:
  • Phone: 603-444-0997
  • Fax: 603-444-6038
Mailing address:
  • Phone: 603-444-2010
  • Fax: 603-444-2181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9789
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number9789
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: