Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath |
NPI | 1326493867 |
---|---|
Provider Name | Michael Williams |
First Address | Newburyport, MA 01950-2774 |
Second Address | Newburyport, MA 01950-2774 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2016 |
Last Update Date | 03/05/2016 |