Provider Demographics
NPI:1225083702
Name:YARBROUGH, WILLIAM D (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:D
Last Name:YARBROUGH
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 1:3601 LADSON RD
Mailing Address - Street 2:STE 100
Mailing Address - City:LADSON
Mailing Address - State:SC
Mailing Address - Zip Code:29456-4304
Mailing Address - Country:US
Mailing Address - Phone:843-285-2500
Mailing Address - Fax:843-285-2505
Practice Address - Street 1:3601 LADSON RD
Practice Address - Street 2:STE 100
Practice Address - City:LADSON
Practice Address - State:SC
Practice Address - Zip Code:29456-4304
Practice Address - Country:US
Practice Address - Phone:843-285-2500
Practice Address - Fax:843-285-2505
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27657207RC0000X, 207RI0011X, 207UN0902X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPA4833Medicaid
SC27657OtherLICENSE #
SCBY9192674OtherDEA #
SC27657OtherLICENSE #
SC27657OtherLICENSE #