Provider Demographics
NPI:1902833171
Name:LELIEVER, WILLIAM C (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:LELIEVER
Suffix:
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 1:1915 K M WICKER MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-5070
Mailing Address - Country:US
Mailing Address - Phone:919-774-6829
Mailing Address - Fax:919-775-2327
Practice Address - Street 1:1915 KM WICKER MEMORIAL DRIVE
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330
Practice Address - Country:US
Practice Address - Phone:919-774-6829
Practice Address - Fax:919-775-2327
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30932207Y00000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8951664Medicaid
NC040001933OtherPALMETTO GBA-RR MEDICARE
NC3404108OtherMEDICAID - HEARING AID CLAIMS
NC8951664Medicaid
NC040001933OtherPALMETTO GBA-RR MEDICARE