Healthcare Provider Details

I. General information

NPI: 1548221161
Provider Name (Legal Business Name): WILLIAM CAMERON WILLIAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 10/25/2020
Certification Date: 09/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 LEWISVILLE CLEMMONS RD DBA FAMILY MEDICAL ASSOCIATES OF LEWISVILLE
LEWISVILLE NC
27023-8251
US

IV. Provider business mailing address

2000 FRONTIS PLAZA BLVD STE 200 (ATTN) FORSYTH MEDICAL GROUP
WINSTON SALEM NC
27103-5616
US

V. Phone/Fax

Practice location:
  • Phone: 336-712-0700
  • Fax: 336-712-0876
Mailing address:
  • Phone: 336-277-2435
  • Fax: 336-277-9275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number29453
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: