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Individual

WILLIAM E WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2880 TRICOM ST, N CHARLESTON, SC 29406-9171
(843) 797-5050
(843) 797-3633
Mailing address
2880 TRICOM ST, N CHARLESTON, SC 29406-9171
(843) 797-5050
(843) 797-3633

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
18102
SC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
18102
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0253030001
DMERC
05
T19334
SC
Enumeration date
08/03/2006
Last updated
03/12/2020
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