Healthcare Provider Details

I. General information

NPI: 1528040854
Provider Name (Legal Business Name): JAMES A WILLIAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 09/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 STONERIDGE DR
COLUMBIA SC
29210-8239
US

IV. Provider business mailing address

PO BOX 2046
WEST COLUMBIA SC
29171-2046
US

V. Phone/Fax

Practice location:
  • Phone: 803-461-3000
  • Fax: 803-461-4910
Mailing address:
  • Phone: 803-461-3000
  • Fax: 803-461-4910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number14607
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: