Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 14112 | SC |
NPI | 1720029747 |
---|---|
Provider Name | William C Giles |
First Address | Columbia, SC 29203-6859 |
Second Address | Columbia, SC 29203-6859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 04/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
141126 | (05) | SC |
620713 | SELECT HEALTH (01) | SC |
F58217 | (02) | |
PA1382 | MEDICAID PTAN (01) | SC |