Dr. Malissa Gail Wilson
Geriatric Medicine
1308 Laurel Street Palmetto Senior Care Laurel
Columbia
, South Carolina 29201
Dr. Malissa Gail Wilson
Geriatric Medicine
1308 Laurel Street Palmetto Senior Care Laurel
Columbia
, South Carolina 29201
(803) 434-3773
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About
Features
Specialties
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- Dr. Malissa Gail Wilson
- 15 Richland Medical Park Palmetto Senior Care Ste 203
- Columbia, SC
- Zip : 29203
- Fax : (803) 434-3773
- Phone : (803) 434-3770
Second Address
- Dr. Malissa Gail Wilson
- 1308 Laurel Street Palmetto Senior Care Laurel
- Columbia, SC
- Zip : 29201
- Fax : (803) 931-8183
- Phone : (803) 931-8166
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0300X | Geriatric Medicine | 14482 | SC |
National Provider Identifier
| NPI | 1073529053 |
|---|---|
| Provider Name | Dr. Malissa Gail Wilson |
| First Address | Columbia, SC 29203 |
| Second Address | Columbia, SC 29201 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/07/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| F46855 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.