Healthcare Provider Details

I. General information

NPI: 1841053816
Provider Name (Legal Business Name): NATHAN EMANUEL WILLIAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 BOILING SPRINGS RD STE 1600
SPARTANBURG SC
29303-4219
US

IV. Provider business mailing address

300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 864-582-6396
  • Fax: 864-542-2939
Mailing address:
  • Phone: 864-695-6697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5434
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: