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WILTON O DEETS III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 343-7000
Mailing address
2430 EMERALD PL STE 201, GREENVILLE, NC 27834-5743
(252) 752-2140

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
193618
NC
367500000X
Certified Registered Nurse Anesthetist
193618
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
4252
NC

Other

Enumeration date
01/10/2007
Last updated
01/27/2022
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