Individual
MR. SEAN MACKEY WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4140 FERNCREEK DR, SUITE 801, FAYETTEVILLE, NC 28314-2563
(910) 484-2171
(910) 484-4568
Mailing address
4140 FERNCREEK DR, SUITE 801, FAYETTEVILLE, NC 28314-2563
(910) 484-2171
(910) 484-4568
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
103952
NC
Other
Enumeration date
02/17/2006
Last updated
07/08/2007
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