MEDICARE: COLUMBIA WILLIAMS

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	374J00000X	Doula

General Provider Information

NPI Number	:	1134720949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLUMBIA WILLIAMS

Provider Business Mailing Address
First Line	:	1066 MENDELL CIR NE
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-2327
Country	:	US
Telephone Number	:	678-834-3979
Fax Number	:

Provider Business Practice Location Address
First Line	:	1066 MENDELL CIR NE
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-2327
Country	:	US
Telephone Number	:	678-834-3979
Fax Number	:

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

Provider Enumeration Date	:	11/06/2020
Last Update Date	:	11/06/2020

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Directions to “ COLUMBIA WILLIAMS ” Practice Location

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