Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | R-9221 | IA |
NPI | 1003100231 |
---|---|
Provider Name | Matthew Helmick Williams |
First Address | Des Moines, IA 50314-1505 |
Second Address | Des Moines, IA 50314-1505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2011 |
Last Update Date | 07/06/2011 |