Individual
RICHARD P WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
701 GROVE RD, 2ND FLOOR ANESTHESIA DEPT, GREENVILLE, SC 29605-5611
(864) 455-7111
(864) 454-1130
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6307
(864) 797-6198
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
85624
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN1510
—
SC
Enumeration date
10/10/2006
Last updated
01/15/2015
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