Healthcare Provider Details

I. General information

NPI: 1134157274
Provider Name (Legal Business Name): CARMEN J WILLIAMS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 08/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 T.W. ALEXANDER DRIVE NIH/NIEHS CRU BUILDING 109
RESEARCH TRIANGLE PARK NC
27709
US

IV. Provider business mailing address

PO BOX 12233 MD E4-05
RESEARCH TRIANGLE PARK NC
27709-2233
US

V. Phone/Fax

Practice location:
  • Phone: 919-541-9899
  • Fax: 919-541-9854
Mailing address:
  • Phone: 919-541-2158
  • Fax: 919-541-0696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD041090E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2008-01487
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: