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Individual

WILLIAM G VAZQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1325 SPRING ST, GREENWOOD, SC 29646-3860
(843) 467-2676
Mailing address
1303 AZALEA CT STE C, MYRTLE BEACH, SC 29577-5765
(843) 467-2676
(843) 497-9566

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
055035
GA
2085R0202X
Diagnostic Radiology Physician
Primary
26692
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
481557006
GA
Enumeration date
01/20/2006
Last updated
07/21/2022
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