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General NPI Number Information
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NPI Number | 1346393006
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Entity Type | Organization
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Legal Business Name | FRED W WILLIAMS MD PC
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1450 PARKSIDE AV SUITE 10
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City | TRENTON
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State | NJ
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Zip | 08638-2950
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Country | US
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Telephone | 609-406-1250
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Fax | 609-406-1249
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Provider Business Mailing Address
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Address Line | PO BOX 5466
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City | TRENTON
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State | NJ
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Zip | 08638-0466
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Country | US
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Telephone | 609-406-1250
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Fax | 609-406-1249
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Authorized Official
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Title or Position | CEO OWNER
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Name | FRED WAYNE WILLIAMS
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Credential | MD
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Telephone | 609-406-1250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MA04097100
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License Number State | NJ
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