# NELMS FAMILY & PREVENTIVE MEDICINE, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912078353
- **Authorized official:** DR. WALLACE R NELMS JR. MD (PRESIDENT)
- **Authorized official phone:** (252) 399-0707

## Contact information

- **Practice address:** 2546 WARD BLVD, WILSON, NC 27893
- **Practice address phone:** (252) 399-0707
- **Practice address fax:** (252) 291-7079
- **Mailing address:** 2546 WARD BLVD, WILSON, NC 27893
- **Mailing address phone:** (252) 399-0707
- **Mailing address fax:** (252) 291-7079

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2000001081876 | NC | Yes |

## Other

- **Enumeration date:** 11/09/2006
- **Last updated:** 06/30/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01471 | BCBS OF NC | — |