Provider Demographics
NPI:1235174012
Name:WEIRS, WILLIAM J (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:WEIRS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7510 NORTHFOREST DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-4247
Mailing Address - Country:US
Mailing Address - Phone:843-572-1600
Mailing Address - Fax:843-572-1795
Practice Address - Street 1:7510 NORTHFOREST DR
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-4247
Practice Address - Country:US
Practice Address - Phone:843-572-1600
Practice Address - Fax:843-572-1795
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA55996207P00000X
SC34694207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA122225872BMedicaid
TN4047309Medicaid
GA057443724EMedicaid
GA057443724DMedicaid
TN4131299OtherBCBS OF TENNESSEE
GAP00342753OtherRAILROAD MEDICARE
GAP00342753OtherRAILROAD MEDICARE
GA057443724EMedicaid