Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204E00000X | Oral & Maxillofacial Surgeon | 10013 | MD |
Y | 204E00000X | Oral & Maxillofacial Surgeon | DEN4886 | DC |
NPI | 1245215821 |
---|---|
Provider Name | Dr. Richard M Williams |
First Address | Washington, DC 20015-2113 |
Second Address | Washington, DC 20015-2113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D00709 | (02) |