Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 16-0810 | NH |
NPI | 1013425453 |
---|---|
Provider Name | Marci Ann Williams |
First Address | Newburyport, MA 01950-3873 |
Second Address | Newburyport, MA 01950-3873 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2018 |
Last Update Date | 19/01/2018 |