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General NPI Number Information
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NPI Number | 1154577419
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Entity Type | Organization
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Legal Business Name | SHELLY L WILLIAMS, DO PLLC
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 318 CENTER ST
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City | MUSKEGON
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State | MI
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Zip | 49445-3113
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Country | US
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Telephone | 231-719-0798
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Fax | 231-744-8570
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Provider Business Mailing Address
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Address Line | 318 CENTER ST
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City | MUSKEGON
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State | MI
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Zip | 49445-3113
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Country | US
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Telephone | 231-719-0798
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Fax | 231-744-8570
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | SHELLY L WILLIAMS
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Credential | DO
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Telephone | 231-719-0798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 5101009366
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License Number State | MI
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