Healthcare Provider Details

I. General information

NPI: 1790728475
Provider Name (Legal Business Name): WILLIAM BILEK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3229 S CHEROKEE LN STE 1400
WOODSTOCK GA
30188
US

IV. Provider business mailing address

3229 S CHEROKEE LN STE 1400
WOODSTOCK GA
30188
US

V. Phone/Fax

Practice location:
  • Phone: 678-445-8181
  • Fax: 678-445-8162
Mailing address:
  • Phone: 678-445-8181
  • Fax: 678-445-8162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number041514
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: