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NPI Code Detail

MEDICARE: DR. GREGORY D WILLIAMS M.D.

MEDICARE:  DR. GREGORY D WILLIAMS  M.D.
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
1207R00000XInternal Medicine PhysicianMD019351EPA
2207RG0300XGeriatric Medicine (Internal Medicine) PhysicianMD019351EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083686216
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY D WILLIAMS M.D.
Provider Business Mailing Address
First Line : 6353 WOODBINE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19151-2523
Country : US
Telephone Number : 215-877-5128
Fax Number : 215-878-4965
Provider Business Practice Location Address
First Line : 6353 WOODBINE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19151-2523
Country : US
Telephone Number : 215-877-5128
Fax Number : 215-878-4965
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 01/26/2010

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