Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | MD450972 | PA |
Y | 213ES0000X | Sports Medicine | MD450972 | PA |
NPI | 1265725204 |
---|---|
Provider Name | Dr. Reed Conly Williams |
First Address | Philadelphia, PA 19129-1302 |
Second Address | Philadelphia, PA 19140 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2011 |
Last Update Date | 06/06/2018 |