Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 5571 | SC |
NPI | 1275563629 |
---|---|
Provider Name | Dr. Luther Chase Williams III |
First Address | Columbia, SC 29203 |
Second Address | Columbia, SC 29203-6859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 02/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
055714 | (05) | SC |
B61649 | (02) |