SAMUEL M WILLIS JR.


Address: 2739 Laurel St, 1-a, Columbia, SC 29204-2028
Phone: 8037994800

SAMUEL M WILLIS JR. (NPI# 1770586588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770586588
Entity Type Individual
Full Name SAMUEL M WILLIS JR.
Credential MD
Practice Address 2739 Laurel St
1-a
Columbia
SC 29204-2028
Mailing Address Po Box 402145
Atlanta
GA 30384-2145
Practice Telephone 8037994800
Practice Fax Number 8032560397
Mailing Telephone 8032963502
Mailing Fax Number 8032967330
Enumeration Date 2005-05-24
Last Update Date 2012-10-16
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RG0100X Internal Medicine
Specialization: Gastroenterology
12083 SC Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
SC 120835 05
SC MEDICARE RAILROAD P01077735 01

Other Providers SAMUEL WILLIS

NPI Name Taxonomy Address Enumeration
1881045060 Samuel Andersen Willis Emergency Medicine 1120 15th St, Augusta, GA 30912-0004 2016-06-28

Office Location

Street Address 2739 LAUREL ST
1-A
City COLUMBIA
State SC
Zip Code 29204-2028

Providers in the same location

NPI Name Taxonomy Address Enumeration
1083617880 Anthony D Lowman Internal Medicine 2739 Laurel St, 1-a, Columbia, SC 29204-2028 2005-05-24
1821553157 Ali Kindal Plyler Nurse Practitioner 2739 Laurel St, Columbia, SC 29204-2028 2019-01-31
1841662483 Katie Livingston Nurse Practitioner 2739 Laurel St, Columbia, SC 29204-2028 2015-10-22
1922490606 Julia Sawyer Nurse Practitioner 2739 Laurel St, Columbia, SC 29204-2028 2015-03-04
1164765723 Amsurg Columbia Anesthesia LLC Nurse Anesthetist, Certified Registered 2739 Laurel St, Suite 1b, Columbia, SC 29204-2028 2013-04-02
1114299575 Palmetto Health Internal Medicine 2739 Laurel St, Suite 1-a, Columbia, SC 29204-2028 2012-02-01
1154384378 Sonya Maria Cook Nurse Practitioner 2739 Laurel St, Columbia, SC 29204-2028 2006-04-10
1356314249 Columbia Asc LLC Clinic/Center 2739 Laurel St, Suite 1b, Columbia, SC 29204-2028 2006-02-10
1922080266 Columbia Gastroenterology Associates Pa Internal Medicine 2739 Laurel St, Suite 1-a, Columbia, SC 29204-2028 2005-11-14
1770564544 John W Popp Internal Medicine 2739 Laurel St, Columbia, SC 29204-2028 2005-11-09
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1992215149 Ricardo Colon II Registered Nurse 3000 Hampton Street, Columbia, SC 29204 2017-10-02
1780113522 Carla Star Noe Registered Nurse Sc Department of Health and Environmental Control, 2100 Bull Street, Collumbia, SC 29204 2017-06-06
1124568514 Kristy L Thompson Nurse Practitioner 1655 Bernardin Ave Ste 240, Columbia, SC 29204 2017-03-03
1982052031 Harold Eugene Cook Iv Podiatrist 1730 St Julian Place, Columbia, SC 29204 2016-05-31
1851748974 Shaquita Banks Counselor 1810 Allen Benedict Ct, A1, Columbia, SC 29204 2016-05-18
1265804835 Premier Care, LLC Case Management 2712 Middleburg Drive, Suite 206, Columbia, SC 29204 2015-10-22
1023492287 Shamiquia N. Mcpherson Counselor 1627 Auburn St., Columbia, SC 29204 2015-07-16
1285028449 The Columbia Free Medical Clinic, Inc. Clinic/Center 1875 Harden Street, Columbia, SC 29204 2015-03-26
1629473459 Leslie Wilson Counselor 2323 Lady Street, Columbia, SC 29204 2014-10-22
1053728683 Candyce Sutton Social Worker 1135 Carter Street, Columbia, SC 29204 2014-07-15
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Taxonomy Information

Taxonomy Code 207RG0100X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Gastroenterology

Taxonomy Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1477160984 Lifebridge Community Physicians Inc Internal Medicine 8875 Centre Park Dr Ste D, Columbia, MD 21045-2382 2020-09-29
1902099336 Ekta Gupta Internal Medicine 10700 Charter Dr Ste 310, Columbia, MD 21044-3730 2007-08-20
1275743221 Eduardo Castillo Del Castillo Internal Medicine 7120 Minstrel Way Ste 100, Columbia, MD 21045-5274 2007-05-22
1679583587 Russell Owen Schub Internal Medicine 8875 Centre Park Dr, Suite D, Columbia, MD 21045-2114 2006-08-09
1992715361 Richard Martin Helman Internal Medicine 6439 Garners Ferry Rd # V, Gastroenterology 2 East, Columbia, SC 29209-1638 2006-08-09
1265470140 Gerald Bertiger Internal Medicine 3 Richland Medical Park Dr Ste 120, Columbia, SC 29203-6850 2006-06-03
1174575294 Nicolas Llorens Internal Medicine 210 Portland St, Suite 100, Columbia, MO 65201-6677 2006-05-17
1376508374 Amit A Choksi Internal Medicine 1222 Trotwood Avenue, Ste 501, Columbia, TN 38401-6422 2006-04-20
1093777310 Daniel Iseman Internal Medicine 1520 Taylor St, Suite 200, Columbia, SC 29201-2901 2006-04-03
1811962517 Lawrence Fredric Sorkin Internal Medicine 10382 Barcan Cir, Columbia, MD 21044-2504 2006-02-17
Find all providers in COLUMBIA

Competitor

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City COLUMBIA
Zip Code 29204

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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