Organization
EXCELSIOR MEDICAL CLINIC, PA
Active
Organization
EXCELSIOR MEDICAL CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH CECIL WILLIAMS MD (PRESIDENT)
(803) 778-2429
Entity
Organization
Contact information
Practice address
448 N MAIN ST, EXCELSIOR MEDICAL CLINIC, PA, SUMTER, SC 29150-4233
(803) 778-2429
(803) 773-6303
Mailing address
448 N MAIN ST, EXCELSIOR MEDICAL CLINIC, PA, SUMTER, SC 29150-4233
(803) 778-2429
(803) 773-6303
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9647
SC
208D00000X
General Practice Physician
9646
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA5850
—
SC
Enumeration date
05/19/2006
Last updated
10/09/2007
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