Provider Demographics
NPI:1720029747
Name:GILES, WILLIAM C (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:GILES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9 RICHLAND MEDICAL PARK DR
Mailing Address - Street 2:STE 510
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6859
Mailing Address - Country:US
Mailing Address - Phone:803-256-2483
Mailing Address - Fax:
Practice Address - Street 1:9 RICHLAND MEDICAL PARK DR
Practice Address - Street 2:STE 510
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6859
Practice Address - Country:US
Practice Address - Phone:803-256-2483
Practice Address - Fax:803-799-4624
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC14112207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPA1382OtherMEDICAID PTAN
SC620713OtherSELECT HEALTH
SC141126Medicaid
F58217Medicare UPIN
SC141126Medicaid