# WILLIAM T CULCLASURE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1205878410
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | A714 | SC | — |
| 363A00000X | Physician Assistant | 714 | SC | Yes |

## Other

- **Enumeration date:** 06/12/2006
- **Last updated:** 11/01/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1068PA | — | SC |
| 01 | — | 576001305006 | BCBS PROVIDER NUMBER | SC |