Provider Demographics
NPI:1275563629
Name:WILLIAMS, LUTHER CHASE III (MD)
Entity Type:Individual
Prefix:DR
First Name:LUTHER
Middle Name:CHASE
Last Name:WILLIAMS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9 MEDICAL PARK
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:803-434-7956
Mailing Address - Fax:803-434-8606
Practice Address - Street 1:9 RICHLAND MEDICAL PARK DR
Practice Address - Street 2:SUITE 110
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6859
Practice Address - Country:US
Practice Address - Phone:803-434-7940
Practice Address - Fax:803-434-2262
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2014-04-02
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Provider Licenses
StateLicense IDTaxonomies
SC55712080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC055714Medicaid
SC055714Medicaid
SCB616492389Medicare PIN
B616492389Medicare ID - Type Unspecified