Provider Demographics
NPI:1215978374
Name:WESSINGER, PHILIP HEYWARD (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:HEYWARD
Last Name:WESSINGER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:727 SE MAIN ST
Practice Address - Street 2:SUITE 220
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-3247
Practice Address - Country:US
Practice Address - Phone:864-454-7422
Practice Address - Fax:864-454-6605
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16504207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4535351OtherAETNA ID
SC576007863130OtherBLUECHOICE HEALTHPLAN ID
SC576007863158OtherBCBS OF SC ID
SC165047Medicaid
SCP00285449OtherRR MEDICARE
SC5231725OtherCIGNA ID
SC576007863130OtherBLUECHOICE HEALTHPLAN ID
SC5231725OtherCIGNA ID
SCP00285449OtherRR MEDICARE