Healthcare Provider Details

I. General information

NPI: 1730191750
Provider Name (Legal Business Name): DONALD HERBERT WILLIAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 ABBOTT RD
EAST LANSING MI
48823-3170
US

IV. Provider business mailing address

921 ABBOTT RD
EAST LANSING MI
48823-3170
US

V. Phone/Fax

Practice location:
  • Phone: 517-351-4237
  • Fax: 517-351-2733
Mailing address:
  • Phone: 517-351-4237
  • Fax: 517-351-2733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301046913
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: