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Individual

DR. WILSON ALARIC VAN DAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1910 BLANDING ST, COLUMBIA, SC 29201-3520
(803) 256-4107
Mailing address
1910 BLANDING ST, COLUMBIA, SC 29201-3520
(803) 256-4107

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD22426
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
224260
SC
Enumeration date
03/08/2006
Last updated
04/07/2025
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