Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 17574 | SC |
NPI | 1497841027 |
---|---|
Provider Name | Donald Williams Wiper III |
First Address | Greenville, SC 29601-2842 |
Second Address | Greenville, SC 29605-4255 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 24/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F83296 | (02) | |
T12518 | (05) | SC |