| Marion A Wills, MD | |
|
450 Old Greenville Hwy, Clemson, SC 29631 | |
| (864) 653-8964 | |
| (846) 653-8963 |
| Full Name | Marion A Wills |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 450 Old Greenville Hwy, Clemson, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194741124 | NPI | - | NPPES |
| 522232 | Medicaid | SC | |
| 000919256D | Medicaid | GA | |
| 117546 | Other | GA | PEACHSTATE MEDICAID |
| 374160 | Other | GA | WELLCARE MEDICAID |
| 000919256A | Medicaid | GA | |
| 000919256E | Medicaid | GA | |
| 300035718A | Medicaid | GA | |
| 830853 | Other | GA | BCBS GEORGIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 049597 (Georgia) | Secondary |
| 208000000X | Pediatrics | 52223 (South Carolina) | Primary |
| Entity Name | Prisma Health University Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295763217 PECOS PAC ID: 8325950983 Enrollment ID: O20031103000238 |
| Entity Name | Prisma Health University Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568799955 PECOS PAC ID: 8325950983 Enrollment ID: O20040108000041 |
| Mailing Address | Practice Location Address |
|---|---|
| Marion A Wills, MD 300 E Mcbee Ave Fl 4, Greenville, SC 29601-2842 Ph: (864) 522-8603 | Marion A Wills, MD 450 Old Greenville Hwy, Clemson, SC 29631 Ph: (864) 653-8964 |
Antoinette Marie Bannister, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 450 Old Greenville Hwy, Clemson, SC 29631 Phone: 864-653-8964 | |
Prasiksha Sitaula, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 885 Tiger Blvd, Clemson, SC 29631 Phone: 864-512-5725 Fax: 864-512-8039 | |
James E Feiste, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 885 Tiger Blvd, Clemson, SC 29631 Phone: 864-512-5890 Fax: 864-512-4711 | |
Elizabeth Anton Chea, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 208 Frontage Rd, Suite 1, Clemson, SC 29631 Phone: 864-654-6034 |