Provider Demographics
NPI:1164520847
Name:ANDERSON, WILLIAM ROBERT (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ROBERT
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3055 WINNERS CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-7406
Mailing Address - Country:US
Mailing Address - Phone:843-860-4336
Mailing Address - Fax:843-875-0028
Practice Address - Street 1:3055 WINNERS CIRCLE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-7406
Practice Address - Country:US
Practice Address - Phone:843-860-4336
Practice Address - Fax:843-875-0028
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13374207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology