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Individual

DR. WILLIAM A. VANHORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
164 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8903
(843) 347-5060
(843) 347-3959
Mailing address
295 OLMSTED BLVD STE 2, PINEHURST, NC 28374-9131
(919) 239-4711
(888) 899-3302

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2014-00886
NC
2084P0805X
Geriatric Psychiatry Physician
2014-00886
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000408404001
BLUE SHIELD
NY
01
050103000028
FIDELIS
NY
01
10091505
CDPHP
NY
01
11398516
CAQH
NY
01
4141636
MVP
NY
01
492BA1
BLUE CROSS
NY
01
AA24050281
MEDICARE PALMETTO GBA
SC
Enumeration date
04/25/2006
Last updated
01/16/2019
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