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General NPI Number Information
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NPI Number | 1598802738
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Entity Type | Individual
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Provider Name | ERIC M. WILLOUGHBY FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 415 MARKET ST
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City | CHERAW
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State | SC
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Zip | 29520-2636
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Country | US
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Telephone | 843-213-6170
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Fax | 843-450-0782
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Provider Business Mailing Address
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Address Line | 206 MCIVER ST
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City | CHERAW
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State | SC
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Zip | 29520-1737
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Country | US
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Telephone | 843-202-9865
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2004000163
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 22477
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 22477
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License Number State | SC
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