Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 37630 | SC |
Y | 111NI0900X | Internist | 37630 | SC |
NPI | 1003295171 |
---|---|
Provider Name | William Cole Andrew |
First Address | Atlanta, GA 30374-3904 |
Second Address | Columbia, SC 29203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2015 |
Last Update Date | 31/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
376300 | (05) | SC |