Individual
MR. ADAM KENNETH WILLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3700 BARRETT DR STE 300, RALEIGH, NC 27609-7172
(919) 782-1806
(919) 782-4756
Mailing address
PO BOX 18563, RALEIGH, NC 27619-8563
(919) 782-1806
(919) 782-4756
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2021-00765
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
2021-00765
NC
207RS0010X
Sports Medicine (Internal Medicine) Physician
2021-00765
NC
Other
Enumeration date
05/02/2017
Last updated
05/11/2026
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