Healthcare Provider Details

I. General information

NPI: 1780597088
Provider Name (Legal Business Name): LOWELL DE'MONTA WILLIAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 MARION BARRY AVE SE APT 712
WASHINGTON DC
20020-5125
US

IV. Provider business mailing address

2300 MARION BARRY AVE SE APT 712
WASHINGTON DC
20020-5125
US

V. Phone/Fax

Practice location:
  • Phone: 202-486-9772
  • Fax:
Mailing address:
  • Phone: 202-486-9772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number374U0000X
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: