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NPI Code Detail

MEDICARE: DR. DANIELLE NICOLE WILLIAMS MD

MEDICARE: DR. DANIELLE NICOLE 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
1111N00000XChiropractor7704AZ
2207V00000XObstetrics & Gynecology PhysicianR73420AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AZ0426440OTHERAZBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1649208059
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIELLE NICOLE WILLIAMS MD
Provider Business Mailing Address
First Line : 5313 E PINCHOT AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85018-8039
Country : US
Telephone Number : 602-309-4020
Fax Number :
Provider Business Practice Location Address
First Line : 5313 E PINCHOT AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85018-8039
Country : US
Telephone Number : 602-309-4020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 02/02/2016

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