Wilson Alaric Van Dam (NPI# 1346218211, PAC ID# 6901982305) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL MEDICINE AND REHABILITATION.
| Nation Provider ID (NPI) | 1346218211 |
| PAC ID by PECOS | 6901982305 |
| Professional Enrollment ID | I20090609000049 |
| Full Name | Wilson Alaric Van Dam |
| Organization Legal Name | PALMETTO BONE AND JOINT PA |
| Address |
104 Ellett Rd Chapin SC 29036-8604 |
| Phone Number | 8648333046 |
| Gender | M |
| Medical School | WRIGHT STATE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1997 |
| Primary Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| Group Practice PAC ID | 4385545565 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420018 | PALMETTO HEALTH RICHLAND |
| 420053 | NEWBERRY COUNTY MEMORIAL HOSPITAL |
| 420073 | LEXINGTON MEDICAL CENTER |
| 420106 | PALMETTO HEALTH BAPTIST PARKRIDGE |
| Address | Phone | Organization |
|---|---|---|
| 104 Ellett Rd, Chapin, SC 29036-8604 | 8648333046 | PALMETTO BONE AND JOINT PA |
| 22971 Hwy 76 E, Clinton, SC 29325 | 8648333046 | PALMETTO BONE AND JOINT PA |
| Organization Legal Name | PALMETTO BONE AND JOINT PA |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John Griz | Orthopedic Surgery | Palmetto Bone and Joint Pa | 22971 Hwy 76 E, Clinton, SC 29325 |
| John M Hibbitts | Orthopedic Surgery | Palmetto Bone and Joint Pa | 104 Ellett Rd, Chapin, SC 29036-8604 |
| Koskie R Gibson | Occupational Therapy | Palmetto Bone and Joint Pa | 104 Ellett Rd, Chapin, SC 29036-8604 |
| Amanda H Smith | Occupational Therapy | Palmetto Bone and Joint Pa | 2605 Kinard St, Suite 105, Newberry, SC 29108-2965 |
| Phillip H Milner | Orthopedic Surgery | Palmetto Bone and Joint Pa | 2605 Kinard St, Suite 105, Newberry, SC 29108-2965 |
| Giridhar Gundu | Physical Medicine and Rehabilitation | Palmetto Bone and Joint Pa | 2605 Kinard St, Suite 105, Newberry, SC 29108-2965 |
| Jacquelyn F Van Dam | Physical Medicine and Rehabilitation | Palmetto Bone and Joint Pa | 2605 Kinard St, Suite 105, Newberry, SC 29108-2965 |
| James Ashley Loging | Orthopedic Surgery | Palmetto Bone and Joint Pa | 2605 Kinard St, Suite 105, Newberry, SC 29108-2965 |
| Mark R Wilson | Orthopedic Surgery | Palmetto Bone and Joint Pa | 2605 Kinard St, Suite 105, Newberry, SC 29108-2965 |
| William S Owens Jr. | Orthopedic Surgery | Palmetto Bone and Joint Pa | 2605 Kinard St, Suite 105, Newberry, SC 29108-2965 |
| Street Address |
104 ELLETT RD |
| City | CHAPIN |
| State | SC |
| Zip | 29036-8604 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John M Hibbitts | Orthopedic Surgery | Palmetto Bone and Joint Pa | 104 Ellett Rd, Chapin, SC 29036-8604 |
| Koskie R Gibson | Occupational Therapy | Palmetto Bone and Joint Pa | 104 Ellett Rd, Chapin, SC 29036-8604 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Caleen N Hawkins | Physical Therapy | Chapin Rehabilitation Clinic Inc | 1525 Chapin Rd, Chapin, SC 29036 |
| Matthew M Whitaker | Physical Therapy | Chapin Rehabilitation Clinic Inc | 1525 Chapin Rd, Chapin, SC 29036 |
| Russell Heath Cogswell | Physical Therapy | Chapin Rehabilitation Clinic Inc | 1525 Chapin Rd, Chapin, SC 29036 |
| Brittany Lynee Powers | Physical Therapy | Chapin Rehabilitation Clinic Inc | 1525 Chapin Rd, Chapin, SC 29036 |
| Heather Lynne Frederick | Physical Therapy | Chapin Rehabilitation Clinic Inc | 1525 Chapin Rd, Chapin, SC 29036 |
| Duncan F Breckenridge Ii | Physical Therapy | Chapin Rehabilitation Clinic Inc | 1525 Chapin Rd, Chapin, SC 29036 |
| Christopher G Lehmann | Chiropractic | 425 C Lexington Ave, Chapin, SC 29036-8092 | |
| Edward W Yeh | Emergency Medicine | Lexington County Health Services District Inc | 557 Columbia Ave, Chapin, SC 29036-8324 |
| Eric Steven Weinstein | Emergency Medicine | Lexington County Health Services District Inc | 557 Columbia Ave, Chapin, SC 29036-8324 |
| Amy S Mcmillan | Physician Assistant | Lexington County Health Services District Inc | 557 Columbia Ave, Chapin, SC 29036-8324 |
| Find all physicians in zip 29036 | |||
| City | CHAPIN |
| Zip Code | 29036 |
| Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| City + Specialty | CHAPIN + PHYSICAL MEDICINE AND REHABILITATION |
Please comment or provide details below to improve the information on Wilson Alaric Van Dam.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.