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:
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Health care specialties

SpecialtyCodeLicense #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 18 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 1720116791 NPPES
North Carolina Other 88903 MEDCOST
North Carolina Other 1163N MEDCOST

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