Provider Demographics
NPI:1043483787
Name:WILLIAM J WESTERKAM
Entity Type:Organization
Organization Name:WILLIAM J WESTERKAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:WESTERKAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-749-0181
Mailing Address - Street 1:320 HARBISON BLVD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-2225
Mailing Address - Country:US
Mailing Address - Phone:803-749-0181
Mailing Address - Fax:803-749-3229
Practice Address - Street 1:320 HARBISON BLVD
Practice Address - Street 2:SUITE 290
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-2225
Practice Address - Country:US
Practice Address - Phone:803-749-0181
Practice Address - Fax:803-749-3229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6229208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC06229Medicaid
SC06229Medicaid