Van Dam, Wilson Alaric
Van Dam, Wilson Alaric is an individual health care provider with primary practice located at 14 Richland Medical Park Dr Suite 200, Columbia SC 29203-6877. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Van Dam, Wilson Alaric can be contacted via phone (803) 296-9200.Contact Information
Primary practice address
14 Richland Medical Park Dr Suite 200
Columbia SC 29203-6877
Phone: (803) 296-9200
Fax: (803) 296-9697
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | T6565 | South Carolina |
Profile Details
NPI number | 1346218211 |
---|---|
LBN Legal business name | Van Dam, Wilson Alaric |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 8th, 2006 |
Last updated | Mar 9th, 2018 - about 7 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 | 1346218211 | NPPES |
South Carolina | MEDICAID | 224260 |
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