Individual
ROBIN A. WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
205 NORTH MAPLE STREET, SUITE 8, SIMPSONVILLE, SC 29681
(864) 963-9149
(864) 967-4727
Mailing address
PO BOX 81055, SIMPSONVILLE, SC 29680-0018
(864) 963-9149
(864) 967-4727
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0727
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007272
—
SC
01
—
576007863071
BLUECHOICE HEALTHPLAN ID
SC
01
—
576007863095
BCBS OF SC ID
SC
01
—
6980369
CIGNA ID
SC
01
—
7268402
AETNA ID
SC
Enumeration date
06/09/2006
Last updated
05/13/2022
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