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Organization
WILSON NEPHROLOGY-INTERNAL MEDICINE PA
Active
Organization
WILSON NEPHROLOGY-INTERNAL MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANWAR D AL-HAIDARY MD (OWNER/PRESIDENT)
(252) 243-2268
Entity
Organization
Contact information
Practice address
2503 WOOTEN BLVD, WILSON, NC 27893
(252) 243-2268
(252) 243-2917
Mailing address
PO BOX 3127, WILSON, NC 27895-3127
(252) 243-2268
(252) 243-2917
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0140N
BLUE CROSS BLUE SHIELD
NC
05
—
890140N
—
NC
Enumeration date
08/26/2005
Last updated
07/21/2022
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