Healthcare Provider Details

I. General information

NPI: 1780047720
Provider Name (Legal Business Name): ALEXIS ANNA WILLIAMS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 10/24/2023
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 OLD LANCASTER RD STE 209
BRYN MAWR PA
19010-3118
US

IV. Provider business mailing address

830 OLD LANCASTER RD STE 209
BRYN MAWR PA
19010-3118
US

V. Phone/Fax

Practice location:
  • Phone: 610-642-3005
  • Fax: 484-337-3559
Mailing address:
  • Phone: 610-642-3005
  • Fax: 484-337-3559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD482459
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: