Doctor Name: | DR. WILLIAM HERNANDEZ-ALICEA |
NPI Number: | 1063421527 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 12487 |
Business Practice Address: | 110 Nnptc Circle Goose Creek Va Out Patient Clinic Goose Creek, SC - 29445 |
Business Phone Number: | 8437896400 |
Business Fax Number: | |
Mailing Address: | 110 Nnptc Circle, Goose Creek Va Out Patient Clinic GOOSE CREEK |
State: | SC |
Postal Code: | 29445 |
Phone Number: | 8437896400 |
Fax Number: | |
NPI Enumeration Date: | 08/05/2006 |
NPI Last Update Date: | 03/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 12487 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |