Provider Demographics
NPI:1417964685
Name:WEBB, C. BLISS (DO)
Entity Type:Individual
Prefix:DR
First Name:C.
Middle Name:BLISS
Last Name:WEBB
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 SALLY HILL FARMS BLVD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6987
Mailing Address - Country:US
Mailing Address - Phone:843-292-8383
Mailing Address - Fax:843-292-8382
Practice Address - Street 1:1822 SALLY HILL FARMS BLVD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6987
Practice Address - Country:US
Practice Address - Phone:843-292-8383
Practice Address - Fax:843-292-8382
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC777207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H74459Medicare UPIN