Individual
DR. BENJAMIN MONTGOMERY WILSON
Active
Individual
DR. BENJAMIN MONTGOMERY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
94373
SC
2085R0202X
Diagnostic Radiology Physician
D91411
MD
2085R0202X
Diagnostic Radiology Physician
LL82423
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL82423
SOUTH CAROLINA LIMITED LICENCE
SC
Enumeration date
06/07/2019
Last updated
07/24/2025
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