Provider Demographics
NPI:1497841027
Name:WIPER, DONALD WILLIAMS III (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:WILLIAMS
Last Name:WIPER
Suffix:III
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 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8301
Mailing Address - Fax:
Practice Address - Street 1:900 W FARIS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4255
Practice Address - Country:US
Practice Address - Phone:864-455-7070
Practice Address - Fax:864-454-4669
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17574207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT12518Medicaid
SCF832967951Medicare PIN
SCF832963640Medicare PIN
F83296Medicare UPIN