Davis, Wiley Mason

Davis, Wiley Mason is an individual health care provider with primary practice located at 11840 Southmore Dr Suite 200, Charlotte NC 28277-4466. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Davis, Wiley Mason can be contacted via phone (704) 384-1166.

Contact Information

Primary practice address
11840 Southmore Dr Suite 200 Charlotte NC 28277-4466
Phone: (704) 384-1166
Fax: (704) 384-1181
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 32309 North Carolina

Profile Details

NPI number 1558334284
LBN Legal business name Davis, Wiley Mason
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Aug 31st, 2023 - about last year

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 1558334284 NPPES
North Carolina MEDICAID 8927894

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