NPI 1144077454

Derrick Dionne Wilson

Practitioner Health Maintenance Organization Winston Salem, NC

Practice location

Address: 500 W 5th St STE 800, Winston Salem, NC 27101-3131
Phone: (800) 571-8308

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 302R000X (NC)

Other Health Maintenance Organization providers in North Carolina →

Registry record

NPI: 1144077454
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 May 2024
Record last updated: 3 May 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.