Individual
TIMOTHY M. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
129 N. WASHINGTON ST., SUMTER, SC 29150
(803) 436-5582
(803) 436-0085
Mailing address
PO BOX 3380, SUMTER, SC 29151
(803) 436-5582
(803) 436-0085
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
17831
SC
207LP2900X
Pain Medicine (Anesthesiology) Physician
17831
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178319
—
SC
Enumeration date
03/23/2006
Last updated
06/14/2022
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