Individual
DR. BEVERLEY DELORIS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 HARBISON WAY STE 221, COLUMBIA, SC 29212-3407
(803) 724-7560
(833) 320-1558
Mailing address
PO BOX 7756, COLUMBIA, SC 29202-7756
(803) 724-7560
(833) 320-1558
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
16075
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160756
—
SC
Enumeration date
12/15/2006
Last updated
12/27/2023
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