Provider Demographics
NPI:1710933551
Name:COBB, WILLIAM SINTON IV (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:SINTON
Last Name:COBB
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 INDEPENDENCE PT STE 212
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4536
Mailing Address - Country:US
Mailing Address - Phone:864-797-6303
Mailing Address - Fax:
Practice Address - Street 1:2104 WOODRUFF RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5941
Practice Address - Country:US
Practice Address - Phone:864-676-1072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26332208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC57-6007863142OtherBCBS OF SC
SC7225489OtherAETNA
SCP00801306OtherRR MEDICARE
SC57-6007863077OtherBLUE CHOICE OF SC
SCN0045AMedicaid
SCP00801306OtherRR MEDICARE
SCN0045AMedicaid
SC57-6007863142OtherBCBS OF SC