Healthcare Provider Details

I. General information

NPI: 1346577616
Provider Name (Legal Business Name): MICHELE WILLIAMS BSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2009
Last Update Date: 01/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 DAVIS DR
MORRISVILLE NC
27560-8845
US

IV. Provider business mailing address

3601 DAVIS DR
MORRISVILLE NC
27560-8845
US

V. Phone/Fax

Practice location:
  • Phone: 919-468-6880
  • Fax:
Mailing address:
  • Phone: 919-468-6880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15590
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: