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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

RAQUEL SHELLY SOLIVAN WILSON, IDMT

Active

RAQUEL SHELLY SOLIVAN WILSON, IDMT is a Independent Duty Medical Technician healthcare provider located in MOODY AFB, Georgia. NPI 1528379732 is currently active in the NPPES registry. Verify at CMS.

Independent Duty Medical Technician · MOODY AFB, GA

Registration Details

NPI Number
1528379732
Provider Type
Individual
Gender
Female
NPI Issued
Jun 23, 2010 (15.953449163666 yrs)
Last Updated
Nov 8, 2023

Practice Information

Address
23 MEDICAL GROUP/SGPF 3278 MITCHELL BLVD BLD 900
MOODY AFB, GA, 316998273
Browse GA providers · Browse ZIP 31699
Phone
2292574685
Fax
2292573242
Primary Specialty
Independent Duty Medical Technician
1710I1003X

Other Independent Duty Medical Technician Providers in MOODY AFB, GA

Name Credential NPI
MR. JAMES MICHAEL WHITE IDMT 1063646230
CHUN CHUNG FONG IDMT 1881905073
JAMES SKY HOWELL IDMT-P 1558673996
MRS. LEIGH ANN JONES IDMT 1194069443
FRANK PAUL YUVAN III IDMT 1508240284
CORY NEWBY IDMT 1821450123
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.