Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 3542 | SC |
N | 1223X0400X | Orthodontists | 0546 | SC |
NPI | 1023168572 |
---|---|
Provider Name | Dr. William Neal Coulter |
First Address | Sumter, SC 29150 |
Second Address | Sumter, SC 29150 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ZA9688 | (05) | SC |