MEDICARE: ANTENEAL WILLIAMS

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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1699402420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTENEAL WILLIAMS

Provider Business Mailing Address
First Line	:	3407 13TH PL SE APT 102
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20032-5028
Country	:	US
Telephone Number	:	202-669-0152
Fax Number	:

Provider Business Practice Location Address
First Line	:	3407 13TH PL SE APT 203
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20032-5028
Country	:	US
Telephone Number	:	202-290-0117
Fax Number	:

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

Provider Enumeration Date	:	08/02/2022
Last Update Date	:	08/08/2022

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Directions to “ ANTENEAL WILLIAMS ” Practice Location

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