Healthcare Provider Details

I. General information

NPI: 1659683746
Provider Name (Legal Business Name): PUJA PATEL WILLIAMS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PUJA DIPAK PATEL M.D.

II. Dates (important events)

Enumeration Date: 07/06/2010
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW G-CCC BUILDING
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

PO BOX 418283
BOSTON MA
02241-8283
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-2116
  • Fax:
Mailing address:
  • Phone: 703-558-1544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number4301096985
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2015-01753
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD78679
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD044222
License Number StateDC
# 5
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number38842
License Number StateSC
# 6
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number074562
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: