MEDICARE: DR. ERIC RASHAD WILLIAMS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	200500678	NC
2	2084P0800X	Psychiatry Physician	22565	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	139VG	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	P00238279	OTHER	NC	RRMC

General Provider Information

NPI Number	:	1013995315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC RASHAD WILLIAMS MD

Provider Business Mailing Address
First Line	:	3555 HARDEN STREET EXT
Second Line	:	15 MEDICAL PARK, SUITE 300
City	:	COLUMBIA
State	:	SC
Zip	:	29203-6894
Country	:	US
Telephone Number	:	803-434-4300
Fax Number	:	803-434-4351

Provider Business Practice Location Address
First Line	:	3555 HARDEN STREET EXT
Second Line	:	15 MEDICAL PARK, SUITE 141
City	:	COLUMBIA
State	:	SC
Zip	:	29203-6894
Country	:	US
Telephone Number	:	803-434-4300
Fax Number	:	803-434-4351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	10/16/2023

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