Larry L Wilson (NPI# 1356345094, PAC ID# 4587562434) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
| Nation Provider ID (NPI) | 1356345094 |
| PAC ID by PECOS | 4587562434 |
| Professional Enrollment ID | I20041213000331 |
| Full Name | Larry L Wilson |
| Organization Legal Name | FETTER HEALTH CARE NETWORK, INC. |
| Address |
35 Walnut St Charleston SC 29403-4514 |
| Phone Number | 8437239477 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE |
| Graduation Year | 1989 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 9032215199 |
| Number of Group Practice Members | 21 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 35 Walnut St, Charleston, SC 29403-4514 | 8437239477 | FETTER HEALTH CARE NETWORK, INC. |
| 51 Nassau St, Charleston, SC 29403-5513 | 8437224112 | FETTER HEALTH CARE NETWORK, INC. |
| 1659 Old Hwy 6, Cross, SC 29436-3602 | 8437532334 | FETTER HEALTH CARE NETWORK, INC. |
| 130 Varnfield Dr, Suite 100, Summerville, SC 29483-7317 | 8438213444 | FETTER HEALTH CARE NETWORK, INC. |
| Organization Legal Name | FETTER HEALTH CARE NETWORK, INC. |
| Physicians | 20 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lorie Jolly | Clinical Social Worker | Fetter Health Care Network, Inc. | 51 Nassau St, Charleston, SC 29403-5513 |
| Dana J Laforte | Nurse Practitioner | Fetter Health Care Network, Inc. | 35 Walnut St, Charleston, SC 29403-4514 |
| Kelly Nicole Morales | Family Medicine | Fetter Health Care Network, Inc. | 3627 Maybank Hwy, Johns Island, SC 29455-4825 |
| Richette Deas | Nurse Practitioner | Fetter Health Care Network, Inc. | 700 Rutledge Ave, Charleston, SC 29403-4145 |
| Glenda Williams | Nurse Practitioner | Fetter Health Care Network, Inc. | 51 Nassau St, Charleston, SC 29403-5513 |
| Kay E Berland | Nurse Practitioner | Fetter Health Care Network, Inc. | 302 Medical Park Dr, Walterboro, SC 29488-5747 |
| Anthony D Poole | Physician Assistant | Fetter Health Care Network, Inc. | 51 Nassau St, Charleston, SC 29403-5513 |
| Kareemah M Stepney | Clinical Social Worker | Fetter Health Care Network, Inc. | 51 Nassau St, Charleston, SC 29403-5513 |
| Matthew Lawrence Gilbert | Physician Assistant | Fetter Health Care Network, Inc. | 51 Nassau St, Charleston, SC 29403-5513 |
| Patricia D Porter | Nurse Practitioner | Fetter Health Care Network, Inc. | 35 Walnut St, Charleston, SC 29403-4514 |
| Street Address |
35 WALNUT ST |
| City | CHARLESTON |
| State | SC |
| Zip | 29403-4514 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dana J Laforte | Nurse Practitioner | Fetter Health Care Network, Inc. | 35 Walnut St, Charleston, SC 29403-4514 |
| Patricia D Porter | Nurse Practitioner | Fetter Health Care Network, Inc. | 35 Walnut St, Charleston, SC 29403-4514 |
| Charles Effiong | Internal Medicine | Fetter Health Care Network, Inc. | 35 Walnut St, Charleston, SC 29403-4514 |
| Rose Delores Gibbs | Internal Medicine | Fetter Health Care Network, Inc. | 35 Walnut St, Charleston, SC 29403-4514 |
| Eleanor R Jenkins-alford | Family Medicine | Fetter Health Care Network, Inc. | 35 Walnut St, Charleston, SC 29403-4514 |
| Sharon Bullard | Nurse Practitioner | Fetter Health Care Network, Inc. | 35 Walnut St, Charleston, SC 29403-4514 |
| Pamela Sherl Johnson | Nurse Practitioner | Fetter Health Care Network, Inc. | 35 Walnut St, Charleston, SC 29403-4514 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Richette Deas | Nurse Practitioner | Fetter Health Care Network, Inc. | 700 Rutledge Ave, Charleston, SC 29403-4145 |
| Carlyn Schwarz | Nurse Practitioner | Fetter Health Care Network, Inc. | 700 Rutledge Ave, Charleston, SC 29403-4145 |
| Courtney Fisher | Urology | 305 Ashley Ave, Charleston, SC 29403-4616 | |
| Beulah M Brooks | Podiatry | 172 Spring St, Charleston, SC 29403-5220 | |
| Lorie Jolly | Clinical Social Worker | Fetter Health Care Network, Inc. | 51 Nassau St, Charleston, SC 29403-5513 |
| Glenda Williams | Nurse Practitioner | Fetter Health Care Network, Inc. | 51 Nassau St, Charleston, SC 29403-5513 |
| Anthony D Poole | Physician Assistant | Fetter Health Care Network, Inc. | 51 Nassau St, Charleston, SC 29403-5513 |
| Kareemah M Stepney | Clinical Social Worker | Fetter Health Care Network, Inc. | 51 Nassau St, Charleston, SC 29403-5513 |
| Matthew Lawrence Gilbert | Physician Assistant | Fetter Health Care Network, Inc. | 51 Nassau St, Charleston, SC 29403-5513 |
| Heather A Rocha | Physician Assistant | Fetter Health Care Network, Inc. | 51 Nassau St, Charleston, SC 29403-5513 |
| Find all physicians in zip 29403 | |||
| City | CHARLESTON |
| Zip Code | 29403 |
| Specialty | OBSTETRICS/GYNECOLOGY |
| City + Specialty | CHARLESTON + OBSTETRICS/GYNECOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.