Healthcare Provider Details

I. General information

NPI: 1902833171
Provider Name (Legal Business Name): WILLIAM C LELIEVER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 10/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 KM WICKER MEMORIAL DRIVE
SANFORD NC
27330
US

IV. Provider business mailing address

1915 K M WICKER MEMORIAL DR
SANFORD NC
27330-5070
US

V. Phone/Fax

Practice location:
  • Phone: 919-774-6829
  • Fax: 919-775-2327
Mailing address:
  • Phone: 919-774-6829
  • Fax: 919-775-2327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number30932
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number30932
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: