Provider Demographics
NPI:1063527398
Name:CAROLINA PULMONARY AND SLEEP
Entity type:Organization
Organization Name:CAROLINA PULMONARY AND SLEEP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-225-5667
Mailing Address - Street 1:2000 EAST GREENVILLE ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1714
Mailing Address - Country:US
Mailing Address - Phone:864-225-5667
Mailing Address - Fax:864-716-6746
Practice Address - Street 1:2000 EAST GREENVILLE ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1714
Practice Address - Country:US
Practice Address - Phone:864-225-5667
Practice Address - Fax:864-716-6746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4557Medicaid
GA111866400AMedicaid
GA111866400AMedicaid