Healthcare Provider Details

I. General information

NPI: 1356782312
Provider Name (Legal Business Name): TAMEKIA WILLIAMSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2013
Last Update Date: 07/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2062 BEECH AVE
CHARLESTON SC
29405-8192
US

IV. Provider business mailing address

2062 BEECH AVE
CHARLESTON SC
29405-8192
US

V. Phone/Fax

Practice location:
  • Phone: 843-200-9974
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278G1100X
TaxonomyGeneral Care Certified Respiratory Therapist
License Number2946
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: