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NPI Code Detail

MEDICARE: DR. AMELIA PUGH WILSON M.D.

MEDICARE:  DR. AMELIA PUGH WILSON  M.D.
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
1207Q00000XFamily Medicine Physician4301065153MI
2207Q00000XFamily Medicine Physician2007-01399NC

Other Identifiers

General Provider Information

NPI Number : 1306810460
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMELIA PUGH WILSON M.D.
Provider Business Mailing Address
First Line : 2000 PERIMETER PARK DR STE 200
Second Line :
City : MORRISVILLE
State : NC
Zip : 27560-8442
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1002 S EUGENE ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27406-1308
Country : US
Telephone Number : 336-271-5999
Fax Number : 336-271-5990
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 08/21/2021

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Directions to “ DR. AMELIA PUGH WILSON M.D.” Practice Location

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