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NPI Code Detail

MEDICARE: WILSON PHU DO

MEDICARE: WILSON PHU DO
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
1208M00000XHospitalist Physician283401MA

General Provider Information

NPI Number : 1770014250
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILSON PHU DO
Provider Business Mailing Address
First Line : 27 PARK ST
Second Line :
City : HYANNIS
State : MA
Zip : 02601-5230
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 27 PARK ST
Second Line :
City : HYANNIS
State : MA
Zip : 02601-5230
Country : US
Telephone Number : 508-862-5976
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2017
Last Update Date : 01/07/2026

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Directions to “ WILSON PHU DO” Practice Location

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