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JOHN DAVID WILSON MD NPI 1679673560


NPI Information

NPI: 1679673560
Provider Name: JOHN DAVID WILSON, MD
Classification: Emergency Medicine - 207PP0204X
Entity Type: Individual

Specialization: Pediatric Emergency Medicine

PECOS Registration: Yes

Address:
701 GROVE RD
ER ADMINISTRATION
GREENVILLE, SC
ZIP 29605
Phone: (864) 455-6372
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John David Wilson, MD is a pediatric emergency medicine emergency medicine in Greenville, SC. The provider is pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department. John David Wilson, MD NPI is 1679673560. 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:

701 GROVE RD
ER ADMINISTRATION
GREENVILLE, SC
ZIP 29605
Phone: (864) 455-6372

The NPI 1679673560 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 9/22/2006 and was last updated on 7/26/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207PP0204XEmergency MedicinePediatric Emergency Medicine14469SOUTH CAROLINAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1576007863OTHERSOUTH CAROLINAUHC
2930129083OTHERSOUTH CAROLINAMEDICARE RAILROAD
3576007863OTHERSOUTH CAROLINABLUE CHOICE
4144695MEDICAIDSOUTH CAROLINA
5576007863OTHERSOUTH CAROLINABCBS
620004420OTHERSOUTH CAROLINASELECT HEATLTH
7576007863OTHERSOUTH CAROLINAAETNA

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.