Healthcare Provider Details

I. General information

NPI: 1801323266
Provider Name (Legal Business Name): PATIENCE A WILLIAMS M D CHILD & ADOLESCENT CENER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2017
Last Update Date: 10/24/2023
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11120 NEW HAMPSHIRE AVE STE 309
SILVER SPRING MD
20904-2680
US

IV. Provider business mailing address

11120 NEW HAMPSHIRE AVE STE 309
SILVER SPRING MD
20904-2680
US

V. Phone/Fax

Practice location:
  • Phone: 301-681-7237
  • Fax: 301-681-7238
Mailing address:
  • Phone: 301-681-7237
  • Fax: 301-681-7238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0046220
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PATIENCE A WILLIAMS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 301-681-7237