Individual
SCOTT DOUGLAS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-8018
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-1332
(336) 716-3202
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2006-00188
NC
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
2006-00188
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10299675
—
VA
01
—
141XM
BCBS
—
01
—
187126
MEDCOST
—
05
—
3810007101
—
WV
01
—
5426596
AETNA
—
05
—
5905701
—
NC
01
—
808940
PARTNERS
—
01
—
P00315168
RR MEDICARE
—
Enumeration date
02/17/2006
Last updated
10/19/2023
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