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NPI Code Detail

MEDICARE: CHAD E WILSON OT

MEDICARE: CHAD E WILSON OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist10199NC

General Provider Information

NPI Number : 1043403629
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHAD E WILSON OT
Provider Business Mailing Address
First Line : 9337 MIAMI BLUFF DR
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-5534
Country : US
Telephone Number : 520-661-2614
Fax Number :
Provider Business Practice Location Address
First Line : 101 E WT HARRIS BLVD STE 5001
Second Line :
City : CHARLOTTE
State : NC
Zip : 28262-3574
Country : US
Telephone Number : 704-583-5763
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2007
Last Update Date : 02/15/2026

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