Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD460807 | PA |
N | 208000000X | Pediatrician | MT206675 | PA |
Y | 2080P0203X | Pediatric Critical Care Doctor | 0101269854 | VA |
N | 2080P0203X | Pediatric Critical Care Doctor | 2021-00293 | NC |
NPI | 1134531304 |
---|---|
Provider Name | Alisha Shante Williams |
First Address | Richmond, VA 23226-1907 |
Second Address | Richmond, VA 23226-1907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2014 |
Last Update Date | 02/02/2021 |