Individual
DR. JAMES M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
744 ARDEN LN, SUITE 225, ROCK HILL, SC 29732-2984
(803) 329-1660
(803) 329-4118
Mailing address
744 ARDEN LN, SUITE 225, ROCK HILL, SC 29732-2984
(803) 329-1660
(803) 329-4118
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01456
NC
174400000X
Specialist
17962
SC
207RR0500X
Rheumatology Physician
Primary
MD17962
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184627317
BLUE CROSS BLUE SHIELD
SC
01
—
88169
BLUE CROSS BLUE SHIELD
NC
05
—
NC8988169
—
NC
05
—
SC179620
—
SC
Enumeration date
05/23/2005
Last updated
10/21/2020
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