MEDICARE: DR. CYNTHIA SUZZANNE WILLIAMS M.D.

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	207Q00000X	Family Medicine Physician	01059453A	IN

General Provider Information

NPI Number	:	1093756348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA SUZZANNE WILLIAMS M.D.

Provider Business Mailing Address
First Line	:	8325 E SOUTHPORT RD
Second Line	:	SUITE 100
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46259-6805
Country	:	US
Telephone Number	:	317-862-6609
Fax Number	:	317-862-4617

Provider Business Practice Location Address
First Line	:	8325 E SOUTHPORT RD
Second Line	:	SUITE 100
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46259-6805
Country	:	US
Telephone Number	:	317-862-6609
Fax Number	:	317-862-4617

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	03/19/2013

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