Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 4301082146 | MI |
N | 207VG0400X | Gynecologist | CW082146 | MI |
NPI | 1144336975 |
---|---|
Provider Name | Dr. Christa B Williams |
First Address | Ann Arbor, MI 48108 |
Second Address | Dexter, MI 48130-8598 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 31/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4516866 | (05) | MA |
H72638 | (02) | MA |