Healthcare Provider Details

I. General information

NPI: 1609237841
Provider Name (Legal Business Name): NAYO SHEPARD WILLIAMS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2016
Last Update Date: 10/11/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 FARMINGTON AVE
FARMINGTON CT
06030-2947
US

IV. Provider business mailing address

10201 GATEWAY BLVD W STE 301
EL PASO TX
79925-7647
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-2792
  • Fax: 860-679-1494
Mailing address:
  • Phone: 915-975-8676
  • Fax: 915-975-8683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number055847
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberS1733
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberS1733
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: