Healthcare Provider Details

I. General information

NPI: 1366409914
Provider Name (Legal Business Name): BARRY NEIL WILLIAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 BETHESDA PL SUITE 801 AND 802
WINSTON-SALEM NC
27103-3331
US

IV. Provider business mailing address

3407 CARVER SCHOOL RD
WINSTON-SALEM NC
27105-4756
US

V. Phone/Fax

Practice location:
  • Phone: 336-659-9141
  • Fax: 336-659-1456
Mailing address:
  • Phone: 336-724-1529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number28820
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: