Provider Demographics
NPI:1962461269
Name:WARLICK, WILLIAM B (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:WARLICK
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 1:200 QUEENS RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3252
Mailing Address - Country:US
Mailing Address - Phone:704-333-7376
Mailing Address - Fax:704-333-3397
Practice Address - Street 1:200 HAWTHORNE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2515
Practice Address - Country:US
Practice Address - Phone:704-384-4188
Practice Address - Fax:704-384-5299
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2002002962085R0001X
SC231492085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1302VOtherBLUE CROSS
7978893001OtherCIGNA
801901OtherPARTNERS
NC891302VMedicaid
SCN00291Medicaid
2210581OtherUNITED HEALTHCARE
B8554OtherMEDCOST
SCH599166058Medicare ID - Type UnspecifiedSC MEDICARE
B8554OtherMEDCOST
920007118Medicare ID - Type UnspecifiedRAILROAD MEDICARE
NC2000066Medicare ID - Type Unspecified
NC2000066BMedicare ID - Type UnspecifiedUNIVERSITY RAD ONC CTR
1302VOtherBLUE CROSS
801901OtherPARTNERS