Healthcare Provider Details

I. General information

NPI: 1104600923
Provider Name (Legal Business Name): ADELLE ANTHONY-WILLIAMS MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1933 JAKE ALEXANDER BLVD W STE 103
SALISBURY NC
28147-1157
US

IV. Provider business mailing address

1933 JAKE ALEXANDER BLVD W STE 103
SALISBURY NC
28147-1157
US

V. Phone/Fax

Practice location:
  • Phone: 704-604-0377
  • Fax: 800-697-5650
Mailing address:
  • Phone: 704-604-0377
  • Fax: 800-697-5650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ADELLE R ANTHONY-WILLIAMS
Title or Position: OWNER, AUTHORIZED OFFICIAL
Credential: MD
Phone: 704-604-0377