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1013913128

NPI Code Detail

MEDICARE: DR. PATRICK ALOYSIUS WILSON MD

MEDICARE: DR. PATRICK ALOYSIUS WILSON MD

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
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	9500774	NC
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	C10004857	DE

General Provider Information

NPI Number	:	1013913128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK ALOYSIUS WILSON MD

Provider Business Mailing Address
First Line	:	200 HAWTHORNE LN
Second Line	:	PRESBYTERIAN HOSPITAL DEPARTMENT OF PATHOLOGY
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-2515
Country	:	US
Telephone Number	:	704-384-4814
Fax Number	:	704-384-5770

Provider Business Practice Location Address
First Line	:	200 HAWTHORNE LN
Second Line	:	PRESBYTERIAN HOSPITAL DEPARTMENT OF PATHOLOGY
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-2515
Country	:	US
Telephone Number	:	704-384-4814
Fax Number	:	704-384-5770

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	03/29/2023

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Directions to “ DR. PATRICK ALOYSIUS WILSON MD” Practice Location

Language	Start Address	Practice Location

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