Individual
STANLEY MCLEAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 DOUGHTY ST, SUITE 660, CHARLESTON, SC 29403-5736
(843) 577-7550
(843) 853-5588
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(888) 472-0043
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
11046
SC
208600000X
Surgery Physician
Primary
11046
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110463
—
SC
01
—
P00739561
RAILROAD MEDICARE ID-RSFPN
SC
01
—
P00775515
RAILROAD MEDICARE ID-AFTER 5/1/2009
SC
Enumeration date
05/01/2006
Last updated
05/28/2025
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