Provider Demographics
NPI:1073569752
Name:WILLIAMS, BRENDA CHAPMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:CHAPMAN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:27150
Mailing Address - Country:US
Mailing Address - Phone:803-778-2429
Mailing Address - Fax:803-773-6303
Practice Address - Street 1:448 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:27150
Practice Address - Country:US
Practice Address - Phone:803-778-2429
Practice Address - Fax:803-773-6303
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC9646208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPA5850Medicaid
SCD907742460Medicare PIN
SCPA5850Medicaid