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Individual

DR. EMANUEL WILLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2630A HARDEE CV, SUMTER, SC 29150-1893
(803) 469-9255
(803) 469-9253
Mailing address
2620 HARDEE CV, SUMTER, SC 29150-1893
(803) 469-9255
(803) 469-9253

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
88
SC
213ES0131X
Foot Surgery Podiatrist
Primary
88
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP9925
SC
05
PD0886
SC
Enumeration date
03/31/2006
Last updated
01/23/2010
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