Healthcare Provider Details

I. General information

NPI: 1235174012
Provider Name (Legal Business Name): WILLIAM J WEIRS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 09/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7510 NORTHFOREST DR
NORTH CHARLESTON SC
29420-4247
US

IV. Provider business mailing address

7510 NORTHFOREST DR
NORTH CHARLESTON SC
29420-4247
US

V. Phone/Fax

Practice location:
  • Phone: 843-572-1600
  • Fax: 843-572-1795
Mailing address:
  • Phone: 843-572-1600
  • Fax: 843-572-1795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number55996
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number34694
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: