Individual
WILLIS ASHTON ENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
169 ASHLEY AVE, ROOM 202 MAIN HOSPITAL, CHARLESTON, SC 29425-8905
(843) 792-2300
Mailing address
169 ASHLEY AVE, ROOM 202 MAIN HOSPITAL, CHARLESTON, SC 29425-8905
(843) 792-2300
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD440173
PA
Other
Enumeration date
05/12/2011
Last updated
05/12/2011
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