Healthcare Provider Details

I. General information

NPI: 1497221915
Provider Name (Legal Business Name): WILLIAM TORRES CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2095 HENRY TECKLENBURG DR
CHARLESTON SC
29414-5733
US

IV. Provider business mailing address

9263 MEDICAL PLAZA DR STE E
CHARLESTON SC
29406-7112
US

V. Phone/Fax

Practice location:
  • Phone: 843-402-1436
  • Fax: 843-402-1833
Mailing address:
  • Phone: 184-357-2122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number22635
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number215639
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: