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General NPI Number Information
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NPI Number | 1003971490
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Entity Type | Individual
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Provider Name | CARL MARC WILLIAMS M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 11104 PARKVIEW CIRCLE DR
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City | FORT WAYNE
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State | IN
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Zip | 46845-1672
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Country | US
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Telephone | 260-373-9700
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Fax | 260-373-9740
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Provider Business Mailing Address
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Address Line | 3400 MINISTRY PKWY
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City | WESTON
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State | WI
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Zip | 54476-5220
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Country | US
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Telephone | 715-393-1000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 016380
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | MD434996
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 60181-20
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 01064129A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 016380
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License Number State | ME
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Taxonomy #6
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | MD434996
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License Number State | PA
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Taxonomy #7
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 60181
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License Number State | WI
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Taxonomy #8
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 60181-20
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License Number State | WI
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Taxonomy #9
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 01064129A
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License Number State | IN
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