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General NPI Number Information
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NPI Number | 1750380671
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Entity Type | Individual
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Provider Name | FRED ANDREW WILLIAMS JR. MD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2005
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Last Update Date | 11/05/2020
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Provider Practice Location Address
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Address Line | 2500 HOSPITAL DRIVE
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City | MARTINSBURG
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State | WV
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Zip | 25401
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Country | US
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Telephone | 304-264-1000
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Fax | 304-264-1374
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Provider Business Mailing Address
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Address Line | PO BOX 1150
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City | MARTINSBURG
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State | WV
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Zip | 25402-1150
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Country | US
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Telephone | 304-264-1000
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Fax | 304-264-1374
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 12261
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 12261
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License Number State | WV
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