MEDICARE: DR. SEAN M MCWILLIAMS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	ME90138	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003854803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEAN M MCWILLIAMS MD

Provider Business Mailing Address
First Line	:	PO BOX 2699
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32513-2699
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7720 US HIGHWAY 98 W
Second Line	:	370
City	:	DESTIN
State	:	FL
Zip	:	32550-7230
Country	:	US
Telephone Number	:	850-622-5148
Fax Number	:	850-622-5149

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	02/21/2014

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