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Organization
CAROLINA ANESTHESIA INC
Active
Organization
CAROLINA ANESTHESIA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY WILSON MD (ANESTHESIOLOGIST)
(803) 765-1838
Entity
Organization
Contact information
Practice address
129 NORTH WASHINGTON ST, SUMTER, SC 29150
(803) 436-5582
(803) 436-0085
Mailing address
PO BOX 3380, SUMTER, SC 29151
(803) 765-1838
(803) 765-1732
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0979
—
SC
Enumeration date
02/02/2006
Last updated
05/18/2015
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