Individual
DR. DENNIS ALONZO WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
602 AIRPORT RD STE C, GREENVILLE, SC 29607-2617
(864) 234-7952
(864) 234-7985
Mailing address
PO BOX 23094, COLUMBIA, SC 29224-3094
(803) 846-3596
(803) 736-7658
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15193
SC
208600000X
Surgery Physician
15193
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151925
—
SC
Enumeration date
11/07/2005
Last updated
02/09/2023
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