Samuel B Wilson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

204052 Issued in MA

Practice address

Diabetes Labs
65 Landsdowne Street
Cambridge, MA 02138

Phone

(617) 768-8883

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376637652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 HOMESTEAD ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024216530",
            "telephone_number": "617-768-8883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DIABETES LABS",
            "address_2": "65 LANDSDOWNE STREET",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02138",
            "telephone_number": "617-768-8883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SAMUEL",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "204052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly R Wilson, PH.D.
• Loren Jay Wilson, DMD
• Lucy Wilson, RN
• Nicholas Wilson, P.T.
• Nikole C Wilson, PHD, LMHC
• Sarah Steuer Wilson
• Emily Winakur, M.S.ED.
• Windsor Health Center
• Windsor Health Center
• Windsor Street Health Center

• Internal Medicine Physician in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.