Individual
DR. FRED HENRY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4431 HWY 220 N, SUMMERFIELD, NC 27358-9411
(336) 643-7711
(336) 643-3047
Mailing address
1701 WESTCHESTER DR, STE 850, HIGH POINT, NC 27262-7254
(336) 802-2000
(336) 802-2534
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29994
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8988293
—
NC
01
—
P00823578
RR MEDICARE
NC
Enumeration date
10/25/2006
Last updated
07/12/2010
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