Female

Carol Wilson MD

Pediatrics Physician in St Petersburg, FL(View on Map)

Full Name

Carol Wilson MD

NPI Number

1376561415

NPI Type

Individual Provider

Gender

Female

Enumeration Date

07/17/2006

Specialties

(Taxonomies)

Code

208000000X

Primary Taxonomy

Yes

Licenses

State

Florida
North Carolina

License Number

ME79468
200700845

Contact
Information

Purpose

Mailing
Location

Address

601 5TH ST S
601 5TH ST S

City

St Petersburg
St Petersburg

State

FL
FL

Postal Code

33701-4804
33701-4804

Country

US
US

Telephone Number

(727) 767-7739
(727) 767-7739

Identifiers

Identifier

78648
891451E
125195254A
265213700

Identifier State

FL
NC
GA
FL

Identifier Issuer

BCBS
Unknown
Unknown
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/16/2013

Provider Address

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