Individual
MR. WILLIAM STEWART KETCHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
29605
NC
207N00000X
Dermatology Physician
29605
NC
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
29605
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0273L
BCBS GROUP NUMBER
NC
01
—
070014474
RR MEDICARE
NC
01
—
290649
MAMSI
NC
01
—
30499
PARTNERS
NC
01
—
3330875-004
CIGNA
NC
01
—
4510902
AETNA
NC
01
—
48795
BCBS IND
NC
01
—
562147357
UHC
NC
01
—
95508
MEDCOST
NC
Enumeration date
01/16/2007
Last updated
10/05/2020
Update your record
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