| Willie B Louis Md Pa | |
|
1102 Summers Ave Orangeburg SC 29115-4922 | |
| (803) 534-2270 | |
| (803) 534-2271 |
| Full Name | Willie B Louis Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1102 Summers Ave, Orangeburg, South Carolina |
| Authorized Official Name and Position | Willie B. Louis (M.D.) |
| Authorized Official Contact | 8035342270 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willie B Louis Md Pa 1102 Summers Ave Orangeburg SC 29115-4922 Ph: (803) 534-2270 | Willie B Louis Md Pa 1102 Summers Ave Orangeburg SC 29115-4922 Ph: (803) 534-2270 |
| NPI Number | 1154534972 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 01/18/2013 |
| Medicare PECOS PAC ID | 5890732705 |
|---|---|
| Medicare Enrollment ID | O20050412001353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154534972 | NPI | - | NPPES |
| GP4128 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 7519 (South Carolina) | Primary |
| Provider Name | Willie Louis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912914284 PECOS PAC ID: 4789621608 Enrollment ID: I20050413000273 |
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