Individual
WICKHAM B SIMONDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
321 MULBERRY ST SW, LENOIR, NC 28645-5720
(843) 237-3378
(843) 237-5073
Mailing address
PO BOX 60445, CHARLOTTE, NC 28260-0445
(843) 237-3378
(843) 237-5073
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200000312
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12641
BCBS
NC
05
—
8912641
—
NC
01
—
P00312178
RAILROAD MEDICARE
NC
Enumeration date
03/28/2006
Last updated
03/17/2009
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