Wilson, Wayne Douglas
Wilson, Wayne Douglas is an individual health care provider with primary practice located at 351 Turnersburg Hwy , Statesville NC 28625-2798. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Wilson, Wayne Douglas can be contacted via phone (704) 871-1712.Contact Information
Primary practice address
351 Turnersburg Hwy
Statesville NC 28625-2798
Phone: (704) 871-1712
Fax: (704) 871-9354
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 3158 | North Carolina |
Profile Details
| NPI number | 1720116791 |
|---|---|
| LBN Legal business name | Wilson, Wayne Douglas |
| Credentials | D.MIN. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 1st, 2007 |
| Last updated | Sep 10th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720116791 | NPPES |
| North Carolina | Other | 88903 | MEDCOST |
| North Carolina | Other | 1163N | MEDCOST |
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