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).
| 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 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
12083 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 120835 | 05 | |
| SC | MEDICARE RAILROAD | P01077735 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881045060 | Samuel Andersen Willis | Emergency Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2016-06-28 |
| Street Address |
2739 LAUREL ST 1-A |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29204-2028 |
| 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 | ||||
| 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 |
| Find all providers in zip 29204 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| 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. |
| 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 | ||||
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| 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.