DR. ROGER M WILSON MD NPI 1245325794

NPI Information

  • NPI: 1245325794
  • Provider Name: DR. ROGER M WILSON, MD
  • Classification: Psychiatry & Neurology - 2084A0401X
  • Specialization: Addiction Medicine
  • Entity Type: Individual
  • Address: DOROTHEA DIX AGENCY
    BANGOR, ME
    ZIP 04401
  • Phone: (207) 944-0733

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NPI Details

DR. Roger M Wilson, MD is an addiction medicine psychiatry neurology in Bangor, ME. The provider is a doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine DR. Roger M Wilson, MD NPI is 1245325794. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

DOROTHEA DIX AGENCY
BANGOR, ME
ZIP 04401
Phone: (207) 944-0733
Fax: (207) 288-3151

The enumeration date for this NPI number is 10/3/2006 and was last updated on 7/9/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084A0401XPsychiatry & NeurologyAddiction Medicine007254MAINEYes
22084P0800XPsychiatry & NeurologyPsychiatryMD7254MAINENo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1010211483MEDICAIDMAINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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