Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD60187949 | WA |
N | 207PE0004X | Emergency Medical Services | 061819 | MI |
N | 207PE0004X | Emergency Medical Services | MD60187949 | WA |
N | 207PP0204X | Pediatric Emergency Physician | MD60187949 | WA |
NPI | 1144273517 |
---|---|
Provider Name | George Andrew Williams |
First Address | Tacoma, WA 98402-3302 |
Second Address | Tacoma, WA 98402-3302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 22/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4136867 | (05) | MI |
4163800 | (05) | MI |
G53947 | (02) | MI |
GW061819 | BLUE CROSS BLUE SHIELD (01) | MI |