Provider Demographics
NPI:1770535726
Name:WILBER, JOSEPH S (PA-C)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:S
Last Name:WILBER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CONNER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7092
Mailing Address - Country:US
Mailing Address - Phone:919-967-8130
Mailing Address - Fax:919-967-3627
Practice Address - Street 1:120 CONNER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7092
Practice Address - Country:US
Practice Address - Phone:919-967-8130
Practice Address - Fax:919-967-3627
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00273363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
411715OtherWELLPATH
0362464OtherCIGNA
2580538OtherUNITED HEALTHCARE
2764777Medicare ID - Type Unspecified
Q56020Medicare UPIN