Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | MD039870E | PA |
NPI | 1003143488 |
---|---|
Provider Name | Dr. Michael Anthony Williams |
First Address | Lansdowne, PA 19050-3005 |
Second Address | Lansdowne, PA 19050-3005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2009 |
Last Update Date | 02/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F24637 | (02) | PA |
FW1853604 | DEA (01) | PA |