Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 52243 | AZ |
N | 2080P0210X | Pediatric Nephrologist | M0971 | TX |
N | 2080P0210X | Pediatric Nephrologist | MD.203262 | LA |
NPI | 1407816341 |
---|---|
Provider Name | Scott Shields Williams |
First Address | Glendale, AZ 85305-2569 |
Second Address | Mesa, AZ 85202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 26/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02822278 | (05) | MS |
148504 | (05) | AZ |
173607601 | (05) | TX |
1755095 | (05) | LA |
I31013 | (02) |