Healthcare Provider Details

I. General information

NPI: 1851725824
Provider Name (Legal Business Name): ASHLEY DENISE WILLIAMS DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 09/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 PHYSICIANS DR
CHARLESTON SC
29414-5719
US

IV. Provider business mailing address

1012 PHYSICIANS DR
CHARLESTON SC
29414-5719
US

V. Phone/Fax

Practice location:
  • Phone: 843-571-0602
  • Fax: 843-571-0605
Mailing address:
  • Phone: 843-571-0602
  • Fax: 843-571-0605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPR 298
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number645
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: