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NPI Code Detail

MEDICARE: EMANUEL CLIFFORD WILLIAMS

MEDICARE: EMANUEL CLIFFORD 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
1104100000XSocial WorkerS.1600600OH

General Provider Information

NPI Number : 1427509801
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMANUEL CLIFFORD WILLIAMS
Provider Business Mailing Address
First Line : 5162 BROADWAY AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44127-1571
Country : US
Telephone Number : 216-938-6826
Fax Number : 216-465-3158
Provider Business Practice Location Address
First Line : 5162 BROADWAY AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44127-1571
Country : US
Telephone Number : 216-938-6826
Fax Number : 216-465-3158
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2016
Last Update Date : 11/23/2016

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Directions to “ EMANUEL CLIFFORD WILLIAMS ” Practice Location

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