Individual
REECE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
455 TOLL GATE RD, WARWICK, RI 02886-2759
(401) 737-7000
Mailing address
10628 PARK RD, CHARLOTTE, NC 28210-8407
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2019-00902
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2015
Last updated
07/15/2019
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