Wilson, Robert A

Wilson, Robert A is an sole proprietor health care provider with primary practice located at 717 N Howe St , Southport NC 28461-3459. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wilson, Robert A can be contacted via phone (910) 363-5075.

Contact Information

Primary practice address
717 N Howe St Southport NC 28461-3459
Phone: (910) 363-5075
Fax: (910) 363-5074
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X NC3312 North Carolina

Profile Details

NPI number 1629189279
LBN Legal business name Wilson, Robert A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 31st, 2006
Last updated Sep 24th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629189279 NPPES
North Carolina Other 128FT BCBS PROVIDER NUMBER
North Carolina MEDICAID 89128FT BCBS PROVIDER NUMBER

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