Organization
SUMTER PODIATRY SERVICES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMANUEL WILLIS DPM (PRESIDENT PODIATRIST)
(803) 469-9255
Entity
Organization
Contact information
Practice address
2620 HARDEE CV, SUMTER, SC 29150-1893
(803) 469-9255
(803) 469-9253
Mailing address
PO BOX 1485, SUMTER, SC 29151-1485
(803) 469-9255
(803) 469-9253
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PDO886
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP9925
—
SC
Enumeration date
03/01/2007
Last updated
10/06/2011
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