Healthcare Provider Details
I. General information
NPI: 1588958953
Provider Name (Legal Business Name): MICHAEL RHODES WILLIAMS M.DIV, M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/02/2011
Last Update Date: 06/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 METROPLEX DR SUITE 150
BIRMINGHAM AL
35209-6893
US
IV. Provider business mailing address
1 METROPLEX DR SUITE 150
BIRMINGHAM AL
35209-6893
US
V. Phone/Fax
- Phone: 205-877-9767
- Fax: 205-877-9768
- Phone: 205-877-9767
- Fax: 205-877-9768
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP1600X |
| Taxonomy | Pastoral Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: