Willis, Park W

Willis, Park W is an individual health care provider with primary practice located at 101 Manning Dr , Chapel Hill NC 27599-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Willis, Park W can be contacted via phone (919) 966-4996.

Contact Information

Primary practice address
101 Manning Dr Chapel Hill NC 27599-0001
Phone: (919) 966-4996
Fax: (919) 843-5515
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 0000-22374 North Carolina

Profile Details

NPI number 1992866040
LBN Legal business name Willis, Park W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Jun 23rd, 2008 - about 16 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 1992866040 NPPES
North Carolina MEDICAID 8988137
North Carolina Other 110126328

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