Individual
FARRA MARTIN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
15 REGIONAL DR, PINEHURST, NC 28374-8850
(910) 295-5511
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-3182
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
173003
NC
207RG0100X
Gastroenterology Physician
Primary
2013-02101
NC
Other
Enumeration date
06/22/2011
Last updated
05/02/2018
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