Healthcare Provider Details

I. General information

NPI: 1467469171
Provider Name (Legal Business Name): ROBERT MICHAEL WILLIAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 KINGSTON AVE
BARRINGTON NJ
08007-1114
US

IV. Provider business mailing address

100 KINGSTON AVE
BARRINGTON NJ
08007-1114
US

V. Phone/Fax

Practice location:
  • Phone: 856-547-1177
  • Fax: 856-547-2509
Mailing address:
  • Phone: 856-547-1177
  • Fax: 856-547-2509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA039291
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: