Organization
WILLIAMSBURG MEDICAL ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PEGGY V MIMS OFFICE MANAGER ASSIS (OFFICE MANAGER ASSISTANT)
(843) 355-7461
Entity
Organization
Contact information
Practice address
500 THURGOOD MARSHALL BLVD, SUITE F, KINGSTREE, SC 29556
(843) 355-7461
(843) 355-3616
Mailing address
500 THURGOOD MARSHALL BLVD, SUITE F, KINGSTREE, SC 29556
(843) 355-7461
(843) 355-3616
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
5526
SC
261QR1300X
Rural Health Clinic/Center
Primary
5526
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055264
—
SC
01
—
428935
RURAL HEALTH MEDICARE
SC
01
—
428935
RURAL HEALTH MEDICARE
TN
05
—
PA7215
—
SC
01
—
RHC103
RURAL HEALTH MEDICAID
SC
Enumeration date
02/05/2007
Last updated
01/10/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up