Individual
DANIEL CULP WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2011
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
2010-00323
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063616423
TRICARE
—
05
—
1063616423
—
VA
05
—
3810017855
—
WV
05
—
5915710
—
NC
01
—
P00844688
MEDICARE RAILROAD
—
05
—
Q0032L
—
SC
Enumeration date
06/12/2007
Last updated
09/28/2017
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