Provider Demographics
NPI:1770029571
Name:BOICE, WILLIAM J (APRN)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:BOICE
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:SC HOUSE CALLS
Mailing Address - Street 2:1053 CENTER STREET
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-6749
Mailing Address - Country:US
Mailing Address - Phone:803-726-2350
Mailing Address - Fax:803-753-9102
Practice Address - Street 1:SC HOUSE CALLS
Practice Address - Street 2:1053 CENTER STREET
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-6749
Practice Address - Country:US
Practice Address - Phone:803-726-2350
Practice Address - Fax:803-753-9102
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC20401363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP4372Medicaid