Individual
DR. TIMOTHY D WINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3240 SUNSET BLVD, WEST COLUMBIA, SC 29169-3428
(803) 796-4251
(803) 796-4449
Mailing address
3240 SUNSET BLVD, WEST COLUMBIA, SC 29169-3428
(803) 796-4251
(803) 796-4449
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24057
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
240572
—
SC
Enumeration date
08/12/2006
Last updated
08/29/2012
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