MEDICARE: MARK S WILLIAMS D.O.

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	OS005170L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	080006831	OTHER	PA	TRAVELERS MEDICARE

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

General Provider Information

NPI Number	:	1215920186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK S WILLIAMS D.O.

Provider Business Mailing Address
First Line	:	305 EVERSON AVE
Second Line	:
City	:	SCOTTDALE
State	:	PA
Zip	:	15683-1512
Country	:	US
Telephone Number	:	724-887-4550
Fax Number	:	724-887-7485

Provider Business Practice Location Address
First Line	:	305 EVERSON AVE
Second Line	:
City	:	SCOTTDALE
State	:	PA
Zip	:	15683-1512
Country	:	US
Telephone Number	:	724-887-4550
Fax Number	:	724-887-7485

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

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	02/12/2008

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Directions to “ MARK S WILLIAMS D.O.” Practice Location

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