WILLIAMSBURG MEDICAL ASSOCIATES PA NPI 1073652137

NPI Information

NPI: 1073652137
Provider Name: WILLIAMSBURG MEDICAL ASSOCIATES PA
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
500 THURGOOD MARSHALL BLVD
SUITE F
KINGSTREE, SC
ZIP 29556
Phone: (843) 355-7461
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WILLIAMSBURG MEDICAL ASSOCIATES PA is a rural health clinic center in Kingstree, SC. WILLIAMSBURG MEDICAL ASSOCIATES PA NPI is 1073652137. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

500 THURGOOD MARSHALL BLVD
SUITE F
KINGSTREE, SC
ZIP 29556
Phone: (843) 355-7461
Fax: (843) 355-3616

The provider's authorized official is Peggy V Mims .
The authorized official title is Office Manager Assistant and has the following contact phone number (843) 355-7461.

The enumeration date for this NPI number is 2/5/2007 and was last updated on 1/10/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		5526	SOUTH CAROLINA	No
2	261QR1300X	Clinic/Center	Rural Health	5526	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	RHC103	OTHER	SOUTH CAROLINA	RURAL HEALTH MEDICAID
2	428935	MEDICARE OSCAR/CERTIFICATION	TENNESSEE
3	428935	OTHER	TENNESSEE	RURAL HEALTH MEDICARE
4	055264	MEDICAID	SOUTH CAROLINA
5	428935	OTHER	SOUTH CAROLINA	RURAL HEALTH MEDICARE
6	C60527	MEDICARE UPIN
7	PA7215	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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