Healthcare Provider Details

I. General information

NPI: 1114973898
Provider Name (Legal Business Name): MICHAEL P WILLIAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 W 7TH AVE SUITE 310
SPOKANE WA
99204-2349
US

IV. Provider business mailing address

2003 KOOTENAI HEALTH WAY
COEUR D ALENE ID
83814-6051
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-7711
  • Fax: 509-747-4664
Mailing address:
  • Phone: 86-255-0842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD33347
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberM-6659
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: