Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 26685 | GA |
NPI | 1346256385 |
---|---|
Provider Name | Charles D Williams |
First Address | Alpharetta, GA 30005-3707 |
Second Address | Alpharetta, GA 30005-3707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 07/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D46866 | (02) | GA |