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General NPI Number Information
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NPI Number | 1942880141
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Entity Type | Individual
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Provider Name | MR. EDWARD WILLIAMS III
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Gender | Male
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Dates
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Enumeration Date | 04/12/2021
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 4846 N 60TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53218-4149
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Country | US
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Telephone | 414-998-6957
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Fax |
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Provider Business Mailing Address
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Address Line | 4846 N 60TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53218
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Country | US
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Telephone |
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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 | 176P00000X
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Taxonomy Name | Funeral Director
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License Number |
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License Number State |
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