Willis, Charles Keith
Willis, Charles Keith is an individual health care provider with primary practice located at 912 Third Street Suite 101, Greensboro NC 27405-6967. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Neuroimaging, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Willis, Charles Keith can be contacted via phone (336) 273-2511.Contact Information
Primary practice address
912 Third Street Suite 101
Greensboro NC 27405-6967
Phone: (336) 273-2511
Fax: (336) 370-0287
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Neuroimaging | 2084D0003X | 33768 | North Carolina |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 33768 | North Carolina |
Profile Details
| NPI number | 1427014497 |
|---|---|
| LBN Legal business name | Willis, Charles Keith |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2006 |
| Last updated | Sep 17th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427014497 | NPPES |
| North Carolina | Other | 130015016 | PALMETTO GBA RR MEDICARE |
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