WILSON INTERNAL MEDICINE PA NPI 1215996046

NPI Information

WILSON INTERNAL MEDICINE PA is a primary care clinic center in Columbia, SC. WILSON INTERNAL MEDICINE PA NPI is 1215996046. The provider is registered as an organization entity type.

The provider's business location address is:

4840 FOREST DR
BOX 255
COLUMBIA, SC
ZIP 29206-810
Phone: (803) 799-0201
Fax: (803) 799-0304

The provider's authorized official is William D. Wilson .
The authorized official title is Physician and has the following contact phone number (803) 799-0201.

The enumeration date for this NPI number is 3/21/2006 and was last updated on 9/9/2008.

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:

Other Identifiers

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

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