Healthcare Provider Details

I. General information

NPI: 1437725959
Provider Name (Legal Business Name): JAMES FREDERICK WEBER PIKE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W HOSPITAL DR
WEST COLUMBIA SC
29169-3405
US

IV. Provider business mailing address

9735 KINCEY AVE STE 201
HUNTERSVILLE NC
28078-9120
US

V. Phone/Fax

Practice location:
  • Phone: 803-796-8515
  • Fax: 803-796-8516
Mailing address:
  • Phone: 704-414-2870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMMD.96406MD
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: