Organization
WILSON INTERNAL MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM D. WILSON JR. M. D. (PHYSICIAN)
(803) 799-0201
Entity
Organization
Contact information
Practice address
4840 FOREST DR, BOX 255, COLUMBIA, SC 29206-4810
(803) 799-0201
(803) 799-0304
Mailing address
4840 FOREST DR, BOX 255, COLUMBIA, SC 29206-4810
(803) 799-0201
(803) 799-0304
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
12953
SC
Other
Enumeration date
03/21/2006
Last updated
09/09/2008
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