Individual
DAMON WILLIAM WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
145 KIMEL PARK DR, SUITE 300, WINSTON SALEM, NC 27103-6984
(336) 768-3212
(336) 768-9019
Mailing address
145 KIMEL PARK DR, SUITE 300, WINSTON SALEM, NC 27103-6984
(336) 768-3212
(336) 768-9019
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
100636
NC
Other
Enumeration date
11/07/2006
Last updated
07/08/2007
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