MEDICARE: GERI M WILLIAMS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	68810	GA
2	207P00000X	Emergency Medicine Physician	ME102408	FL

General Provider Information

NPI Number	:	1073769568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERI M WILLIAMS MD

Provider Business Mailing Address
First Line	:	1613 HARRISON PKWY
Second Line	:	SUITE 200, BLDG C
City	:	SUNRISE
State	:	FL
Zip	:	33323-2896
Country	:	US
Telephone Number	:	954-838-2502
Fax Number	:	954-851-1758

Provider Business Practice Location Address
First Line	:	1170 CLEVELAND AVE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30344-3615
Country	:	US
Telephone Number	:	770-874-5400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2008
Last Update Date	:	04/20/2022

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