Physician Compare National (NPI:1457455529)

HEALTHCARE PROVIDER: TERRY EDWARD WILLIAMS MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1457455529
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6204976038
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20091229000497
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WILLIAMS
	Individual professional last name
Provider First Name	TERRY
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1972
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	625 KENT AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 309
	Group Practice or individual's line 2 address
City	CUMBERLAND
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	215023754
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	210027
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WESTERN MARYLAND REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y