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1578561304

NPI Code Detail

MEDICARE: MICHAEL GREGORY WILLIAMS MD

MEDICARE: MICHAEL GREGORY WILLIAMS MD

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	207P00000X	Emergency Medicine Physician	MW049187	MI
2	208D00000X	General Practice Physician	4301049187	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00943709	OTHER	MI	RAILROAD MEDICARE IND PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0108118302	OTHER	MI	BCBS IND

General Provider Information

NPI Number	:	1578561304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL GREGORY WILLIAMS MD

Provider Business Mailing Address
First Line	:	20411 W 12 MILE RD STE 102
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-6404
Country	:	US
Telephone Number	:	248-905-3194
Fax Number	:	248-905-3548

Provider Business Practice Location Address
First Line	:	20411 W 12 MILE RD STE 102
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-6404
Country	:	US
Telephone Number	:	248-905-3194
Fax Number	:	248-905-3548

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	01/18/2026

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Directions to “ MICHAEL GREGORY WILLIAMS MD” Practice Location

Language	Start Address	Practice Location

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