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Organization
WILSON INTERNAL MEDICINE PA
Active
Organization
WILSON INTERNAL MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEDHAT F SIDAROS MD (PRESIDENT)
(252) 291-8600
Entity
Organization
Contact information
Practice address
2402 CAMDEN ST SW STE B500, WILSON, NC 27893-8608
(252) 291-8600
(252) 291-6914
Mailing address
PO BOX 3544, WILSON, NC 27895-3544
(252) 291-8600
(252) 291-6914
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9600733
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5900812
—
NC
Enumeration date
04/23/2007
Last updated
03/11/2015
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