MEDICARE: CHELSEA DAWN 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	374700000X	Technician

General Provider Information

NPI Number	:	1295202521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA DAWN WILLIAMS

Provider Business Mailing Address
First Line	:	1505 GREENDALE RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21218-2238
Country	:	US
Telephone Number	:	757-709-8114
Fax Number	:

Provider Business Practice Location Address
First Line	:	1505 GREENDALE RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21218-2238
Country	:	US
Telephone Number	:	757-709-8114
Fax Number	:

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

Provider Enumeration Date	:	10/24/2018
Last Update Date	:	10/24/2018

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Directions to “ CHELSEA DAWN WILLIAMS ” Practice Location

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