Daleya Shiree Wilson, BACHELOR DEGREE
Individual provider Active NPI Driver · Columbia, SC
NPI 1659173441 · NPPES record last updated Mar 25, 2025
Key facts
- NPI
- 1659173441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- 101629600 (SC)
- Practice address
- 201 Gayle Pond Trce
Columbia, SC 29209-2734 - Phone
- (803) 201-3584
- NPI assigned
- Mar 25, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101629600 | SC | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver |
172A00000X | 101629600 | SC | Yes |
Addresses
Primary practice location
201 Gayle Pond Trce
Columbia, SC 29209-2734
Mailing address
1606 Wynnewood Rd
Columbia, SC 29223-3636
Phone (803) 201-3584
Other practice location 1
1606 Wynnewood Rd
Columbia, SC 29223-3636
Phone (803) 201-3584
Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.