Individual
DR. BRIAN EDWARD WYSONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2290 REMOUNT RD, GASTONIA, NC 28054-4725
(704) 867-1402
(888) 720-2814
Mailing address
2550 COURT DR STE 201, GASTONIA, NC 28054-2152
(704) 867-1402
(704) 671-2661
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2006-00934
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5905656
—
NC
Enumeration date
07/09/2006
Last updated
11/14/2023
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