Individual
PAMELA S WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
457-B HWY 123 BYPASS, SENECA, SC 29678-0842
(864) 888-4464
(864) 888-4462
Mailing address
457-B HWY 123 BYPASS, SENECA, SC 29678-0842
(864) 888-4464
(864) 888-4462
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A632
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1060
—
SC
05
—
RHC195
—
SC
Enumeration date
01/16/2006
Last updated
06/14/2012
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